慢性阻塞性肺疾病院内感染的病原菌分布及耐药性分析

Distribution and drug-resistance of pathogenic bacteria of nosocomia infection from patients with chronic obstructive pulmonary disease

目的了解慢性阻塞性肺疾病 (COPD)院内感染病原菌分布及耐药情况 ,为临床治疗COPD院内感染合理选用抗生素提供依据。方法对 4 3例COPD院内感染患者的痰培养及药敏结果进行分析。结果 4 3株细菌中革兰阴性杆菌感染占 81 4 % ,其中铜绿假单孢菌占 2 3 3% ,克雷伯杆菌占 18 4 % ,不动杆菌占 14 0 % ;药敏结果发现 :革兰阴性杆菌的耐药率分别为氨苄西林90 6 %、头孢唑啉 90 6 %、头孢他啶 15 6 %、头孢哌酮 2 1 9%、哌拉西林 9 4 %、阿米卡星 15 6 %、左氧氟沙星 18%、亚胺培南9 4 % ,铜绿假单孢菌对亚胺培南、哌拉西林敏感。结论COPD院内感染以革兰阴性杆菌为主 ,亚胺培南、哌拉西林、头孢他啶 ,阿米卡星、左氧氟沙星的抗菌活性最强 ,可作为COPD院内感染病人的经验性用药。临床应尽量开展药敏试验 ,根据当地耐药情况 ,合理选用或交替使用抗生素 ,尽量减少耐药菌的产生。

Objective To investigate the distribution and drug-resistance of pathogenic bacteria of nosocomia infection from in-patients with chronic obstructive pulmonary disease(COPD).Methed Sputum culture and drug sensitivity test were conducted for 43 patients with COPD. Results Among 43 bacteria, gram-negative bacillus occupied 81.4%,of which pseudomonas aeruginoea ,klebsiella pneumoniae and acinetobacter baumannii was about 23.3%,18.4%, 14.0%,respectively.Drug sensitivity test indicated drug-resistance rate of gramnegative bacillus were in sequence Ampicillin 90.6%、Cefazolin 90.6%、Ceftazidime15.6%、Cefoperazone 21.9%、Piperacillin 9.4%、Amikixine 15.6%、Levofloxacin18%、Imipenem 9.4%.Pseudomonas aeruginoea was sensitive to Imipenem and Pipperacillin. Conclusion: Gram-negative bacillus are the dominant pathogenic bacteria of nosocomia infection from patients with COPD, and the drug sensitivity test is helpful to instruct properly use of antibiotics.