AECOPD患者呼吸道感染病原菌及药敏分析

目的探讨老年慢性阻塞性肺病急性加重期（AECOPD）呼吸道病原菌群的分布及分析药敏试验结果。方法对我院老年呼吸病房及呼吸病特色诊疗中心住院的120例AECOPD患者的痰细菌培养和药敏试验结果进行分析。结果COPD急性加重期感染的病原菌中，革兰氏阴性杆菌占65．69％，以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希氏菌、鲍曼不动杆菌为主；革兰氏阳性球菌占28．43％，以肺炎链球菌、葡萄球菌为主；真菌占5．88％；一种以上病原菌混台感染占5．0％。细菌体外药敏试验发现：亚胺培南、头孢吡肟、头孢他啶、哌拉西林、罗米沙星对大部分革兰阴性杆菌有较好敏感性，亚胺培南、头孢毗肟、头孢他啶、万古霉素对大部分革兰阳性球菌有较好敏感性，本组真菌对氟胞嘧啶、两性霉素、氟康唑、伊曲康唑均敏感。结论AECOPD分离的细菌以革兰氏阴性杆菌为主，真菌感染率较高，应引起重视。各病原菌对多种抗菌药物的耐药率有上升趋势。

Bacteriology and antimicrobial sensitivity in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To investigate the bacterial flora and antimicrobial sensitivity in sputum from patients with acute exacerbations of chronic obstructive pulmonary disease（AECOPD） in order to recommend the best empirical treatment for these patients. Methods A total of 120 patients with AECOPD were included. Their sputa were investigated by microscopy, culture and sensitivity testing. Among the 120 patients, 102（ 85% ） had a positive sputum culture. The majority of patients with positive sputum cultures were infected with bacteria mostly Gram-negative bacteria such as Klebsiella pneumoniae, S. pneumoniae and colon bacillus. The sensitivity patterns of the bacteria showed that the majority were resistant to penicillin. If antibiotics are initiated empirically for AECOPD we recommend third and fourth generation cephalosporins for treatment. Conclusion In AECOPD patients, Gram-negative bacteria are more frequent in COPD patients and have higher drug resistance than other patient populations.