老年肺部感染病人致病菌耐药情况及耐药程度对血清IL-6、IL-10、CRP水平的影响

doi:10.3969/j.issn.1003-9198.2025.01.019

摘要/Abstract

摘要： 目的探讨老年肺部感染病人致病菌耐药情况及耐药程度对血清IL-6、IL-10、CRP水平的影响。方法选取2020年5月至2023年5月运城市中心医院收治的214例老年肺部感染病人,分析其致病菌耐药情况,并探讨致病菌种类、耐药程度对血清IL-6、IL-10、CRP水平的影响,采用Spearman法分析血清IL-6、IL-10、CRP水平与不同致病菌耐药程度的相关性。结果 214例老年肺部感染病人的痰标本共检出病原菌265株,革兰氏阴性菌、革兰氏阳性菌占比分别为76.23%(202/265)、23.77%(63/265)。其中,一般耐药47例(21.96%),多重耐药105例(49.07%),广泛耐药62例(28.97%)。革兰氏阴性菌感染病人与革兰氏阳性菌感染病人的耐药情况比较,差异无统计学意义(P＞0.05);革兰氏阴性菌感染病人血清IL-6、IL-10、CRP水平均高于革兰氏阳性菌感染病人(P＜0.05),且在同种类致病菌感染病人中,一般耐药病人IL-6、IL-10、CRP水平低于多重耐药病人,多重耐药病人低于广泛耐药病人(P＜0.05)。Spearman秩相关分析结果显示,革兰氏阴性菌或革兰氏阳性菌感染病人血清IL-6、IL-10、CRP水平与致病菌耐药程度均呈正相关(P＜0.05)。结论老年肺部感染致病菌以革兰氏阴性菌为主,且多重耐药菌占比较高。血清IL-6、IL-10、CRP水平与致病菌耐药程度存在相关性,临床可根据血清炎症因子水平初步判定致病菌耐药程度,合理使用抗生素。

关键词: 老年人, 肺部感染, 致病菌, 耐药程度, 白细胞介素-10, C反应蛋白, 白细胞介素-6

Abstract: Objective To investigate the drug resistance of pathogenic bacteria in the elderly patients with pulmonary infection and the effects of drug resistance degree on the serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and C-reactive protein (CRP). Methods A total of 214 elderly patients with pulmonary infection hospitalized in Yuncheng Central Hospital from May 2020 to May 2023 were selected to analyze the drug resistance of pathogenic bacteria, and the effects of species and drug resistance of pathogenic bacteria on the levels of serum IL-6, IL-10 and CRP were investigated. The correlation of serum IL-6, IL-10, CRP with the drug resistance degree of different pathogens was analyzed by Spearman correlation analysis. Results A total of 265 strains of pathogenic bacteria were detected in the sputum samples of 214 elderly patients with pulmonary infection. The proportion of Gram-negative bacteria and Gram-positive bacteria was 76.26% (202/265) and 23.77% (63/265), respectively. Of all cases, 47 cases showed general drug resistance (21.96%), and 105 cases showed multi-drug resistance (49.07%) and 62 cases showed extensive drug resistance (28.97%). There was no significant difference in drug resistance between the patients infected with Gram-negative bacteria and those infected with Gram-positive bacteria (P>0.05), but the serum levels of IL-6, IL-10 and CRP in the patients infected with Gram-negative bacteria were higher than those in the patients infected with Gram-positive bacteria (P <0.05). The levels of IL-6, IL-10 and CRP in the patients presenting with general drug resistance were lower than those in the patients presenting with multi-drug resistance, and the levels of IL-6, IL-10 and CRP in the patients presenting with multi-drug resistance were lower than those in the patients presenting with extensive drug resistance (P <0.05). Spearman correlation analysis showed that the levels of serum IL-6, IL-10 and CRP were positively correlated with the degree of drug resistance (P<0.05). Conclusions Gram-negative bacteria are the main pathogens in the elderly patients with pulmonary infection, and the proportion of multi-drug resistance is relatively high. The levels of serum IL-6, IL-10 and CRP are correlated with the degree of drug resistance of pathogenic bacteria. The degree of drug resistance of the pathogenic bacteria can be preliminarily estimated according to the levels of serum inflammatory factors, which can be used to guide the rational use of antibiotics in clinic.

Key words: aged, lung infection, pathogenic bacteria, drug resistance, interleukin-10, C-reactive protein, interleukin-6

中图分类号:

R 563.1

李婷, 裴军芳, 孙珊珊. 老年肺部感染病人致病菌耐药情况及耐药程度对血清IL-6、IL-10、CRP水平的影响[J]. 实用老年医学, 2025, 39(1): 83-87.

LI Ting, PEI Junfang, SUN Shanshan. Drug resistance of pathogenic bacteria and effects of drug resistance degree on serum levels of IL-6, IL-10 and CRP in elderly patients with pulmonary infection[J]. Practical Geriatrics, 2025, 39(1): 83-87.

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