慢性阻塞性肺疾病急性加重期呼吸道感染的病原菌分布和药敏分析

目的分析慢性阻塞性肺疾病(简称慢阻肺)急性加重期呼吸道感染的病原菌分布和药敏分析,为临床初治提供依据。方法回顾性分析我院呼吸内科2012年1月至2014年12月期间的慢阻肺患者487例,痰液细菌培养结果及药敏分析。结果 487例慢阻肺急性加重期呼吸道感染患者中分离出病原菌334株,其中革兰氏阴性菌243株,占72.8%,革兰氏阳性菌58株,占17.3%,真菌33株,占9.9%;革兰氏阴性菌为主要病原菌,其中肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌为感染的主要病原菌,药敏结果显示对碳青酶烯类、氨基糖甙类、哌拉西林他唑巴坦敏感性高,对头孢他啶、头孢西丁、头孢呋辛、环丙沙星、左氧氟沙星耐药性高。患者住院次数2/年、住院时间2周、气管插管、机械通气、留置胃管为多重耐药菌感染的相关因素(P0.05)。结论慢阻肺急性加重期呼吸道感染以革兰氏阴性菌为主,注重多重耐药菌的危险因素,根据痰培养及药敏结果合理选用抗菌药物。

Pathogenic bacteria distribution and drug sensitivity test for AECOPD patients with respiratory tract infec-tion

Objective To analyze the pathogenic bacteria distribution and drug sensitivity analysis in AECO-PD patients with respiratory tract infection so as to provide the guidance for clinical treatment. Methods The clini-cal data of 487 AECOPD patients with respiratory tract infection from January 2012 to December 2014 were enrolled to analyze their sputum bacterial culture Results and drug sensitivity retrospectively. Results 334 strains of patho-genic bacteria were isolated from sputum specimens of 487 AECOPD patients with respiratory tract infection, inclu-ding 243 strains of gram-negative bacteria (72. 8%), 58 strains of gram-positive bacteria (17. 3%) and 33 strains of fungi ( 9. 9%) . Gram-negative bacteria were dominant, mainly including Klebsiella pneumoniae, pseudomonas aeruginosa and escherichia coli. Drug sensitivity Results showed that the main Gram-negative bacteria were sensi-tive to carbon blue enzyme alkenes, aminoglycosides and droperidol piperacillin tazobactam and resistant to ceftazi-dime, cefoxitin, cefuroxime, ciprofloxacin and levofloxacin. The related factors for multiple drug resistant bacteria in-fections included hospitalization number >2 years, hospital >2 weeks, tracheal intubation, mechanical ventilation and indwelling gastric tube (P<0. 05). Conclusion The gram-negative bacteria are the main pathogenic bacterium of AECOPD patients with respiratory tract infection. We need to pay great attention to the related factors and rational-ly use antibiotics according to the results of sputum culture and drug sensitivity tests.