COPD死亡病例医院获得性支气管-肺感染

目的为了解ＣＯＰＤ死亡病例医院获得性支气管－肺感染的状况。方法采用痰半定量培养技术结合胸水、血培养及经皮肺穿刺物培养对５７例ＣＯＰＤ死亡病例进行了前瞻性研究。结果本组病例医院获得性支气管－肺感染的发病率为４３．８６％，发病前全部使用１种或两种以上抗生素，最高者达８种；７０％患者使用过糖皮质激素。致病菌主要为Ｇ－杆菌（９５．５％），其中以不动杆菌为多见，复合感染及真菌感染较多。部分病例普通痰培养结果并不能确定致病菌。结论不动杆菌已在ＣＯＰＤ医院获得性支气管－肺感染中占有很重要地位。确定致病菌应结合Ｘ线等辅助检查和临床状况综合。

Study of nosocomial bronchopulmonary infection with COPD clinical death

OBJECTIVE In order to know the state of nosocomial bronchopulmonary infection of COPD clinical deaths was studiea. METHODS Semi-quantitative sputum culture, blood culture, culture of pleural fluid were used in a prospective study of 57 COPD clinical deaths. RESULTS The morbidity was 43.86%. At least one kind of antibiotics were used in all cases. 40 cases (70%) had a history of corticosteroid therapy. The predominant pathogens were Gram-negative bacilli (95.5%), the most were Acinetobacter. Common sputum culture was not reliable in some cases. CONCLUSION It is suggested that patients who had a long period therapy of corticosteroid, inappropriate antibiotic therapy, or depressed immunity function were increased risk of nosocomial bronchopulmonary infections. The diagnosis should be made according to bacteriologic examination combined with the clinical and X-ray manifestations.