AECOPD病原菌分布与耐药性分析

发布时间：2018-03-15 07:19

本文选题：慢性阻塞性肺疾病急性加重期　切入点：病原学　出处：《安徽医科大学学报》2015年01期 　论文类型：期刊论文

【摘要】：目的了解慢性阻塞性肺疾病急性加重期(AECOPD)患者细菌感染的病原菌分布特点及耐药性情况。方法回顾性分析近6年来安徽医科大学第一附属医院老年呼吸内科740例AECOPD患者的痰培养及药敏结果。结果740例患者的痰培养阳性率为39.1%。314株阳性菌中革兰阴性细菌196株,占62.4%,常见菌依次为铜绿假单胞菌、鲍曼溶血不动杆菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌、大肠埃希菌。革兰阳性细菌21株,占总数6.7%,常见菌依次为溶血葡萄球菌、肺炎链球菌、金黄色葡萄球菌。真菌97株,占总数30.9%,最常见的是白色假丝酵母菌。革兰阴性细菌普遍对第3代头孢菌素、青霉素类抗生素耐药,对氨基糖苷类中度耐药,亚胺培南耐药性较低。革兰阳性细菌对大部分抗生素均有不同程度耐药,仅对利奈唑胺、万古霉素保持较高敏感性。真菌对抗真菌药普遍较敏感。结论 AECOPD患者细菌感染多以革兰阴性细菌为主,耐药性普遍。加强病原菌检测、掌握病原菌分布及耐药情况,为临床合理使用抗生素提供依据,从而减缓耐药菌的产生与传播。
[Abstract]:Objective to investigate the distribution and drug resistance of bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods 740 cases of geriatric respiratory department in the first affiliated Hospital of Anhui Medical University in recent 6 years were retrospectively analyzed. Results the positive rate of sputum culture in 740 patients with AECOPD was 39.1%, among which 196 were Gram-negative bacteria. The most common bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus maltophilia, Escherichia coli, Escherichia coli, Gram-positive bacteria. Streptococcus pneumoniae, Staphylococcus aureus, 97 strains of fungi, accounting for 30.9% of the total, the most common is Candida albicans. Gram-negative bacteria are generally resistant to the third generation of cephalosporins, penicillin antibiotics, and moderately resistant to aminoglycoside. The resistance of imipenem was low. Gram-positive bacteria were resistant to most antibiotics to varying degrees, only to linazolamide, Vancomycin maintained high sensitivity. Fungal antifungal agents were generally sensitive. Conclusion Gram-negative bacteria are the main bacterial infection in patients with AECOPD, and drug resistance is common. To provide the basis for the rational use of antibiotics and to slow down the production and transmission of drug-resistant bacteria.
【作者单位】：安徽医科大学第一附属医院老年呼吸内科;
【基金】：安徽高校省级自然科学研究项目(编号:KJ2009A118)
【分类号】：R446.5

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