中-重度COPD患者上腹部术后下呼吸道感染菌株的耐药性分析

目的探讨中-重度慢性阻塞性肺病(Chronic Obstmetive Pulmonary Diserse．COPD)患者上腹部手术后下呼吸道感染株的分布及耐药性．为临床合理用药提供依据。方法随机选择我院2002年1月-2004年12月收治的行上腹部手术的中-重度COPD患者59例．对经检验分离的78株细菌以纸片扩散法(KB法)行药敏测定分析。结果78株细菌中主要致病菌依次为铜绿假单胞菌、不动杆菌、肺炎克雷伯菌、阴沟杆菌、粪肠球菌、金黄色葡萄球菌居分离菌前6位。药敏结果表明：亚胺培南、头孢他啶、头孢哌酮，舒巴坦、阿米卡星为大多数细菌敏感．但对青霉素类及头孢菌素类抗生素耐药性明显增强。结论中一重度COPD患者上腹部手术后下呼吸道感染以G^-菌为主。围手术期合理使用抗生素可以使耐药性降低。

Analysis of classification and drug resistance of bacteria in patients with mild-severe COPD after upper abdominal operation

Objective To investigate the classification, the drug resistance of bacteria in lower respiratory tract after upper abdominal operation in patients with mild-severe COPD. Methods 59 Patients after upper abdominal operation with mild-severe COPD in surgical intensive care unit (SICU) from Jan to Dec 2004 were chosen randomly. The classification, the drug resistance of bacteria of 78 bacterium isolated from these patients were analyzed by KB methods. Results In 78 strains, there were 61(78.2%) strains of gram negative bacteria and 17(17.6%) strains of grams positive bacteria. The main bacteria included staphylococcusaureus, E. faecium, Enterobacter cioacae, Escerichiacholi, Pseudomonasaeruginosa in the first six top. Most of those bacteria were sensitive with Imipenem & Cilastatin, Ceftazidime, Cefoperazone Sodium and Sulbactam Sodium and Amikacin Sulfate. Drug resistance with penicilline and cefo increased significantly.Conclusion The gram negative bacteria were main bacteria in patients with COPD after upper abdominal operation. During preioperation, antimicrobial agents correct use can decrease drug-resistance.