慢性阻塞性肺病下呼吸道院内感染痰培养分析

Analysis of Bacterial Cultures of Sputum from 184 Cases of Chronic Obstructive Pulmonory Diseases with Hospital-Aquired Low Airway Infection

目的 :了解慢性阻塞性肺病下呼吸道院内感染的病原菌分布及药敏情况。方法 :对 2 6 5例慢性阻塞性肺病 (COPD)下呼吸道院内感染患者进行痰细菌培养分离 ,并对分离出的细菌进行药物敏感试验 (药敏 )。结果 :184例培养阳性 ,阳性率 6 9 4% ;共检出细菌 2 2 4株 ,以革兰阴性 (G-)杆菌为主 (76 3 % ) ;2种以上细菌混合感染 40例 (2 1 7% ) ;金黄色葡萄球菌 (金葡菌 )、不动杆菌、铜绿假单胞菌及阴沟杆菌为主要致病菌。药敏发现头孢他定、妥布霉素、头孢曲松、氧氟沙星、万古霉素为敏感抗生素。结论 :COPD下呼吸道多种细菌混合感染常见 ,且耐药严重。临床上应加强药敏测定 ,合理应用抗生素 ,联合用药 。

Objective: To analyse the pathogen of chronic obstructive pulmonary diseases(COPD) with low respiratory tract infection.Methods:Becterial cultures of sputum from 265 cases of COPD with low respiratory tract infection were performed and drug sensitivity was tested among positive cases. Results:184 cases were positive (69.4%) and 224 strains becteria were obtained. 40 patients(21.7%) were infected by two or more kinds of becteria.The main pathogens were staphylococcus aureus, acinetorbacter,pseudomonas aeruginosa and enterobacter cloacae.Drug sensitivity test showed that ceftazidime,vancomycin,tobramycin,ceftrioxome,ofloxacin were effective drugs. Conclusion:Low respiratory tract infection by becteria in patients with COPD was common and drug resistence rate of microbe was very high.So drug sensitivity test should be done more often and antibiotics must be selected according to the test.