慢性阻塞性肺病患者呼吸道感染的病原菌及耐药性分析

Analysis of pathogen and their antibiotic resistance in respiratory infection of chronic obstructive pulmonary disease

为了解慢性阻塞性肺病（ＣＯＰＤ）急性发作患者呼吸道感染的病原菌及耐药情况，对我院１９９１～１９９５年９０８例ＣＯＰＤ住院患者的痰培养结果进行分析。结果：从４９４例ＣＯＰＤ患者痰标本中分离出７４４株细菌，主要为革兰氏阴性菌（８０％），其中铜绿假单胞菌占２２．８％，克雷伯氏菌属占２１．１％。革兰氏阳性菌中主要为金葡球菌（１２．６％）。药敏分析发现，金葡球菌对青霉素、氨苄西林、红霉素的耐药率达７０．５％、５３．５％和７３．５％。假单胞菌属、克雷伯氏菌属、肠杆菌科细菌对氨苄西林的耐药率超过９０％，对头孢唑林的耐药率分别达８７．９％、１４．８％和６５．５％。结果提示：ＣＯＰＤ患者呼吸道感染的病原菌以革兰氏阴性菌为主，需有效、合理地选用抗生素。

In order to understand the pathogen and their antibiotic resistance in respiratory infection of patients with chronic obstructive pulmonary disease (COPD), we had investigated on sputum culture of 908 case with COPD in recent five years. Results revealed that 744 strains of bacteria were isolated from sputum samples of 494 cases, and which were dominated by Gram negative bacteria (80%), including Pseudomonas aeruginosa (22.8%) and Klebsiella (21.1%). The main Gram positive bacterium was Staphylococcus aureus (12.6%). Antibiotic sensitivity test showed that the resistance rates of Staphylococcus aureus to penicillin, ampicillin, erythromycin were 70.5%, 53.5% and 73.5% respectively. The resistance rates of pseudomonas, Klebsiella and enterobacteriaceae to ampicillin were over 90%, and to cefazolin were 87.9%, 14.8% and 65.5% respectively. Results suggested that the pathogen of COPD patients with acute respiratory infection were dominated by Gram negative bacteria and more effective antibiotics were necessary in controlling the respiratory infection of patients with COPD.