慢性阻塞性肺疾病并肺部感染病原菌分析

发布时间：2018-08-21 13:34

【摘要】：目的分析慢性阻塞性肺疾病(COPD)合并肺部感染患者的细菌学特点及药物敏感性。方法按常规方法收取278例COPD合并肺部感染患者的痰液,观察细菌培养及药敏结果。结果 COPD合并肺部感染主要为铜绿假单胞菌(22.13%)、肠杆菌属(14.50%)、流感嗜血杆菌(13.74%)、肺炎克雷伯杆菌(12.21%)等革兰氏阴性杆菌,其次为链球菌、金葡菌及表皮葡萄球菌等革兰氏阳性球菌(26.71%),真菌占11.45%。亚胺培南、衣替米星、头孢吡肟等都有较好的敏感性,革兰氏阳性球菌对万古霉素未显示耐药。铜绿假单胞菌对亚胺培南耐药性有增高趋势(耐药率31.03%),哌拉西林/他唑巴坦抗铜绿假单胞菌活性与头孢他啶相近。结论 COPD并肺部感染常见病原菌为铜绿假单胞菌、肠杆菌属、流感嗜血杆菌等,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、左氧氟沙星、亚胺培南、头孢吡肟等有较高敏感性。亚胺培南对铜绿假单胞菌耐药增加,而哌拉西林/他唑巴坦显示一定的优越性。G+球菌对万古霉素敏感,真菌感染应予重视。
[Abstract]:Objective to analyze the bacteriological characteristics and drug sensitivity of patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary infection. Methods sputum samples from 278 patients with COPD complicated with pulmonary infection were collected by routine method and the results of bacterial culture and drug sensitivity were observed. Results Pseudomonas aeruginosa (22.13%), Enterobacter (14.50%), Haemophilus influenzae (13.74%), Klebsiella pneumoniae (12.21%), Streptococcus spp. Gram-positive cocci such as Staphylococcus aureus and Staphylococcus epidermidis (26.71%), fungi accounted for 11.45%. Imipenem, itemicin and cefepime were all sensitive to vancomycin. Gram-positive cocci were not resistant to vancomycin. The resistance of Pseudomonas aeruginosa to imipenem increased (resistance rate was 31.03%), and the activity of piperacillin / tazobactam against Pseudomonas aeruginosa was similar to that of ceftazidime. Conclusion the common pathogens of COPD complicated with pulmonary infection are Pseudomonas aeruginosa, Enterobacter influenzae, Haemophilus influenzae and so on. Cefoperazone / sulbactam, piperacillin / tazobactam, levofloxacin, imipenem, etc. Cefepime was highly sensitive. The resistance of imipenem to Pseudomonas aeruginosa increased, while piperacillin / tazobactam showed some advantages.
【作者单位】：北京市垂杨柳医院呼吸科;
【分类号】：R563.9

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