慢性阻塞性肺疾病患者痰培养细菌耐药分析

目的研究慢性阻塞性肺病(COPD)患者伴发呼吸道感染的痰中病原菌及耐药情况。方法回顾性调查分析504例COPD患者痰培养和细菌耐药性的临床资料。结果 COPD患者504例共送痰标本609次,培养出病原菌属480株,包括G+菌属63株(13.12%)和G-菌属417株(86.88%)。痰标本培养出各菌属中对9个菌属进行耐药性分析,结果发现对头孢类抗生素耐药性最高,大多数在60%以上。504例COPD患者中有164例经验性治疗未发现抗生素耐药性,感染控制不佳的224例根据痰培养更换或联用抗生素后感染多数得到控制,有65例因耐药性严重,感染无法控制最终死于肺部感染,住院病死率为13.69%。结论 COPD患者的呼吸道感染病菌多为革兰阴性菌,常用抗生素耐药明显,提倡合理使用抗生素是防止细菌耐药的关键。

Analysis of Bacteria and Drug Resistance in the Sputum of Patients with Chronic Obstructive Pulmonary Diseases

Objective To investigate the information of pathogenic bacteria and drug resistance in the sputum of patients with chronic obstructive pulmonary diseases(COPD).Methods A retrospective investigation was adopted to analyze the results of sputum culture and susceptibility tests of 504 patients with COPD.Results 480 strains of pathogenic bacteria were found in 609 samples of sputum culture,including 417(86.88%)strains of Gram-negative and 63(13.12%)strains of Gram-positive bacteria.9 species of the cultured bacteria were researched for drug resistance,and it′s discovered that the highest resisted drug was cephalosporins,most over 60%.Among 504 patients with COPD,164 cases were in good agreement with empirical treatment,most of the 224 cases of poor infection control,were under control after replacement or joint use of the antibiotics according to sputum culture,65 cases died from pulmonary infection due to the serious drug resistance,hospital mortality 13.69%.Conclusion The respiratory infection in patients with COPD was mainly due to Gram-negative bacteria,which were resistant to common antibiotics.Rational use of antibiotics promotion is the key to prevent bacterial resistance.