支气管扩张不同病理分型合并感染的病原学及药敏分析

【目的】调查支气管扩张不同病理分型合并感染的病原学特点及药敏情况。【方法】回顾性分析不同病理分型合并感染的356例支气管扩张患者的痰培养和药敏结果。【结果】356例患者痰标本致病菌检测阳性219例（61．5％）。囊状支气管扩张以金黄色葡萄球菌、溶血性葡萄球菌、铜绿假单胞菌为主，对万古霉素、利奈唑胺敏感；柱状支气管扩张以革兰阴性杆菌铜绿假单胞菌、肺炎克雷白杆菌、鲍曼不动杆菌为主，菌株对亚胺培南、美罗培南、第三、四代头孢菌素及氟喹诺酮类抗生素敏感性较高，氨基糖苷类抗生素中阿米卡星敏感性较高；曲张型支气管扩张以菌铜绿假单胞菌、肺炎克雷白杆菌、阴沟肠杆菌为主，药物敏感性同柱状支气管组。混合型支气管扩张以菌铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌为主，药物敏感性同t。【结论】支气管扩张合并感染的致病菌分布特点与病理分型有一定相关性，合理选用抗菌药物对减少耐药菌的产生有重要作用。

Analysis of etiology and antibiotic susceptibility in infection complicated in bronchiectasis with different pathologic classification

Objective]To investigate the etiology of bronchiectasis of different pathological types of co-infection and their antibiotic susceptibility analysis to provide a basis for rational clinical use of antimicrobial drugs. Method ] Sputum culture and drug sensitivity of 356 patients with bronchiectasis concurrent infection were retrospectively analyzed. Results]Positive sputum culture was obtained from 356 patients,with the positive rate 61.5 %. The most colnnlon pathogen of cystic bronchiectasis are Staphylococcus aureus, hemolytic staphylococci, and Staphylococcus aureus,high sensitivity of vancomycin, linezolid. The most colunlon pathogen of cylindrical bronchiectasis are pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, high sensitivity of imipenem, meropenem, third and fourth generation cephalosporins, fluoroquinolones and amikacin sensitive; The most colunlon pathogen of varicose bronchiectasis are pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae dominated, the drug sensitivity as cylindrical bronchiectasis group. The most colunlon pathogen of Mixed hronchiectasis are pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, drug sensitivity as above. Conclusion ]The pathogen distribution of bronchiectasis was correlated to pathologic types of hronchiectasis. It is suggested that reasonable use of antibiotics is very important to reduce drug resistance.