| 合并支气管扩张的慢性阻塞性肺疾病急性加重期患者病原谱及耐药性分析 |
| 投稿时间：2014-09-28 修订日期：2014-11-13 点此下载全文 |
| 引用本文：刘平莉.合并支气管扩张的慢性阻塞性肺疾病急性加重期患者病原谱及耐药性分析[J].医学研究杂志,2015,44(10):131-134 |
| DOI：
10.11969/j.issn.1673-548X.2015.10.037 |
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| 中文摘要:目的 探讨合并支气管扩张的急性加重期慢性阻塞性肺疾病(AECOPD)感染病原菌分布及其耐药情况,指导临床合理用药。 方法 选择笔者医院2010年1月~2014年4月住院的98例合并支气管扩张的COPD急性加重期患者为研究对象,对所有患者痰标本中分离出的病原菌进行菌种鉴定和耐药性分析。 结果 共分离出66株病原菌,其中,革兰阴性杆菌52株,占78.8%;革兰阳性球菌5株,占7.6%;真菌9株,占13.6%。最主要的革兰阴性杆菌依次为铜绿假单胞菌(27.3%)、大肠杆菌(13.6%)、肺炎克雷伯菌(12.1%)、鲍曼不动杆菌(10.6%)、阴沟肠杆菌(7.6%)。革兰阳性球菌以金黄色葡萄球菌(4.5%)为主。革兰阴性杆菌耐药现象均较普遍,对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星敏感度较高。金黄色葡萄球菌未发现对万古霉素耐药。 结论 合并支气管扩张的COPD急性加重期感染致病菌以革兰阴性杆菌为主,其次为真菌、革兰阳性球菌。细菌耐药情况较为严重,应结合本地区病原菌分布特点及耐药状况,合理选用抗菌药物。 |
| 中文关键词:急性加重 慢性阻塞性肺疾病 支气管扩张 病原菌 耐药性 |
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| Analysis of Pathogens Distribution and Drug Resistance in Acute Exacerbation of Coexisting Chronic Obstructive Pulmonary Disease and Bronchiectasis |
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| Abstract:Objective To explore the distribution and antibiotic resistance of pathogenic bacteria isolated from sputum of patients with acute exacerbation of coexisting chronic obstructive pulmonary disease(COPD) and bronchiectasis, so as to guide the rational antimicrobial application in clinical practise. Methods Bacteria culture and drug susceptibility testing were performed for the sputum samples of 98 hospitalized patients with acute exacerbation of coexisting COPD and bronchiectasis from January 2010 to April 2014. Results A total of 66 strains of pathogenic bacteria were isolated in 96 patients, including 52 strains of Gram-negative bacilli(78.8%), 5 strains of Gram-positive cocci (7.6%) and 9 strains of fungi(13.6%). The five predominant Gram-negative bacterial species were P.aeruginosa(27.3%), Escherichia coli(13.6%), Klebsiella pneumonia (12.1%), Acinetobacter baumannii(10.6%), and Enterobacter cloacae(7.6%).The effective antibiotics against Gram-negative bacterial infection in patients with acute exacerbation of coexisting COPD and brochiectasis included carbapenems, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin. All the S. aureus strains in this stuy were sensitive to vancomycin. Conclusion The Gram-negative bacilli are the main pathogens in acute exacerbation of coexisting COPD and brochiectasis, followed by fungi and Gram-positive bacteria. As the problem of bacterial resistance is getting worse, antibiotics should be used more rationally according to the distribution of common pathogens and drug resistance trends in the region. |
| keywords:Acute exacerbation Chronic obstructive pulmonary disease Brochiectasis Pathogen Drug resistance |
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