慢性阻塞性肺疾病急性加重期患者感染病原菌及耐药性分析

发布时间：2018-11-09 10:32

【摘要】：目的分析慢性阻塞性肺疾病急性加重期患者感染病原菌种类及分布特征和耐药性。方法选取2012年1月至2015年1月在郏县人民医院接受治疗的慢性阻塞性肺疾病急性加重期患者190例。在患者入院后24 h内采痰标本,然后对标本进行培养,染色镜检,分离鉴定病原菌种类。对常见病原菌使用抗菌药物进行药敏试验,判断病原菌耐药性。结果 190例患者共分离病原菌230株。其中革兰阳性菌25株(10.87%),革兰阴性菌194株(84.35%),真菌11株(4.78%)。革兰阴性菌构成比明显高于革兰阳性菌和真菌,差异有统计学意义(P0.05)。其中,铜绿假单胞菌48株,占20.87%,是最常见的病原菌,其次为鲍曼不动杆菌和肺炎克雷伯杆菌,各占19.13%、16.96%。铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯杆菌对氨苄西林耐药率均较高,分别为97.91%、68.18%以及97.44%;三种病原菌对左旋氧氟沙星耐药率较低,分别为25.00%、52.27%和10.26%。结论慢性阻塞性肺疾病急性加重期病原菌感染主要为革兰氏阴性菌,其中,铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯杆菌是常见病原菌,对不同病原菌进行药敏试验,观察其耐药性对于提高治疗效果至关重要。
[Abstract]:Objective to analyze the types and distribution of pathogenic bacteria and drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods 190 patients with acute exacerbation of chronic obstructive pulmonary disease who were treated in Jiaxian people's Hospital from January 2012 to January 2015 were selected. The sputum samples were collected within 24 hours after admission, and then the specimens were cultured, stained with microscope, and the pathogenic bacteria were isolated and identified. Antimicrobial susceptibility test was used to judge the drug resistance of common pathogens. Results 230 strains of pathogenic bacteria were isolated from 190 patients. There were 25 Gram-positive bacteria (10.87%), 194 Gram-negative bacteria (84.35%) and 11 fungi (4.78%). The composition ratio of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria and fungi (P0.05). Among them, 48 strains of Pseudomonas aeruginosa, accounting for 20.87, were the most common pathogens, followed by Acinetobacter baumannii and Klebsiella pneumoniae, accounting for 19.1313 and 16.96 respectively. Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae showed higher resistance to ampicillin, 97.91% and 97.44%, respectively. The resistance rates of the three pathogens to levofloxacin were 25.00% and 10.26%, respectively. Conclusion Gram-negative bacteria are the main pathogens of acute exacerbation of chronic obstructive pulmonary disease, among which Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae are common pathogens. It is very important to observe the drug resistance in order to improve the therapeutic effect.
【作者单位】：郏县人民医院呼吸科;
【分类号】：R563.9

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