老年人阻塞性肺疾病下呼吸道感染病原菌及其耐药性分析

目的：了解老年慢性阻塞性肺病(COPD)下呼吸道感染病原菌，为临床诊治提供依据。方法：对120例老年COPD患者的痰培养及药敏结果进行分析。结果：从120例老年COPD患者的痰标本中分离出84株细菌，革兰阴性菌占77．4％，其中铜绿假单胞菌占26．2％，克雷伯杆菌占14．3％，大肠埃希菌占10．7％。药敏分析发现：革兰阴性杆菌耐药率依次为：对氨苄西林耐药率为93．0％，哌拉西林20．1％，丁胺卡那11．4％，亚胺培南(或西司他丁)7．3％，铜绿假单胞菌对亚胺培南(或西司他丁)、哌拉西林敏感。结论：老年COPD患者下呼吸道感染病原菌以革兰阴性杆菌为主，应根据药敏结果和临床实效合理选用抗生素。

A Study on Pathogenic Bacteria of the Infection of Inferior Respiratory Tract of Elderly Patients with COPD and the Bacterial Drug Resistance

Objective: To increase knowledge to acute infection in inferior respiratory tract of elderly patients with chronic obstructive pulmonary disease ( COPD). Methods: Sputum culture and drug sensitivity test were conducted for 120 elderly patients with COPD. Results: 84 strains of pathogenic bacteria were found in sputum samples from 120 subjects. Among these bacteria, gram -negative pathogenic bacteria occupied 77. 4% , of which Micrococcus pyocyaneus was 26. 2% , Klebasiella 14. 3% , and Escherichia coli 10. 7%. Drug sensitivity test results indicated the drugs and the resistance rates of the pathogenic bacteria to them were, in sequence, Imipenem - cilastatin 7. 3% , Amikin 11.4% , Piperacillin 20, 1% and Ampicillin 93% . Micrococcus pyocyaneus was sensitive to Imipenem - cilastatin and Piperacillin. Conclusion: Gram -negative pathogenic bacteria are the dominant pathogens of acute infection in inferior respiratory tract of elderly patients with COPD, and the drug sensitivity test results are significant in instructing of properly use of antibiotics.