2015-2016年襄阳市中医医院慢性阻塞性肺疾病急性加重期患者呼吸道病原菌分布及耐药性分析

目的 分析襄阳市中医医院慢性阻塞性肺疾病急性加重期患者呼吸道病原菌分布及耐药情况,为临床合理使用抗菌药物提供依据.方法 对2015—2016年襄阳市中医医院慢性阻塞性肺疾病急性加重期患者呼吸道病原菌的分布及耐药性进行回顾性分析.结果 共分离出病原菌376株,其中革兰阳性菌146株,占38.83%;革兰阴性菌209株,占55.59%;真菌21株,占5.58%.革兰阳性菌耐药率位于首位的为金黄色葡萄球菌,其次为表皮葡萄球菌、溶血葡萄球菌,对这3种细菌耐药率较低的有万古霉素、替考拉宁.革兰阴性菌中耐药率位于首位的是铜绿假单胞菌,其次为大肠埃希菌,对细菌耐药率较低的抗生素为亚胺培南、美罗培南.结论 慢性阻塞性肺疾病急性加重期患者的主要致病菌为革兰阴性菌,且耐药率较高,临床上应结合地区常见致病菌分布及耐药流行趋势,正确选择敏感抗菌药物.

Analysis on distribution and drug resistance of pathogenic bacteria from respiratory tract of patients with acute exacerbation of chronic obstructive pulmonary disease in Xiangyang Hospital of Traditional Chinese Medicine from 2015 to 2016

Objective To analyze the distribution and drug resistance of pathogenic bacteria from respiratory tract of patients with acute exacerbation of chronic obstructive pulmonary disease in Xiangyang Hospital of Traditional Chinese Medicine, and to provide reference for clinical rational drug use. Methods The distribution and drug resistance of pathogenic bacteria from respiratory tract of patients with acute exacerbation of chronic obstructive pulmonary disease in Xiangyang Hospital of Traditional Chinese Medicine from 2015 to 2016 were analyzed retrospectively. Results Total 376 strains of pathogens were isolated, in which Gram-positive bacteria (146 strains) accounted for 38.83%, Gram-negative bacteria were 209 strains (55.74%), and fungi (21 strains) accounted for 5.58%. The drug resistance rate of Staphylococcus aureus ranked first in Gram-positive bacteria, followed by S. epidermidis and S. aureus. Vancomycin and teicoplanin were sensitive to these three bacteria. The drug resistance rate of Pseudomonas aeruginosa ranked first in Gram-negative bacteria, followed by Escherichia coli. Imipenem and meropenem were sensitive to the bacteria. Conclusion The main pathogenic bacteria of patients with acute exacerbation of chronic obstructive pulmonary disease is Gram-negative bacteria, and the drug resistance rate is high. It should be combined with the distribution of common pathogens and the trend of drug resistance in the region to select sensitive antimicrobials.