目的:分析老年脓毒症休克患者病原菌的特点。方法:回顾性分析60例老年脓毒症休克患者的病原学资料,其中死亡组34例、存活组26例,比较两组患者一般资料、感染部位、病原学特点及病原菌药敏情况等。结果:老年脓毒症休克患者感染病灶有1.4(1.0,3.0)个,病灶主要为肺部、腹腔、泌尿系统;标本病原菌阳性检出率为43.7%;39例(65%)患者检出病原菌,其中G~-菌58.3%、真菌41.7%、合并细菌及真菌36.7%、G~+菌5.0%;对G~-菌敏感性≥60%的药物仅有碳氢酶烯类抗生素。两组病灶类型及数量、病原菌类型及数量等比较,差异无统计学意义(P>0.05)。结论:老年脓毒症休克的主要病原菌为高耐药性的G~-菌,且常合并真菌感染,在保证强有力抗G~-菌的同时应重视抗真菌治疗。 Objective: To analyze the characteristics of pathogens in elderly septic shock patients. Methods: The etiological data of 60 elderly patients with septic shock were retrospectively analyzed. Among them, 34 patients died and 26 patients survived. The general data, infection site, etiological characteristics and drug susceptibility of pathogens in two groups were compared. Results: There were 1.4 (1.0, 3.0) cases of infection in septic shock in elderly patients. The main lesions were lung, abdominal cavity and urinary system. The positive rate of pathogenic bacteria was 43.7%, and 39 (65%) were pathogenic bacteria , Of which 58.3% were G ~ - bacteria, 41.7% were fungi, 36.7% were bacteria and fungi, and 5.0% were G ~ + bacteria; only those with 60% sensitivity to G ~ - bacteria had only histamine resistance. There were no significant differences in the type and number of lesions, pathogen types and numbers between the two groups (P> 0.05). Conclusion: The main pathogens of sepsis in elderly patients are highly resistant G ~ - bacteria, and often associated with fungal infection, in ensuring strong anti - G ~ - bacteria should also attach importance to antifungal therapy.