老年COPD并社区获得性肺炎常见病原菌及耐药性分析

Distribution and antim icrobial resistance of pathogenic strains from sputum sample of patients of community acquired pneumonia with chronic obstructive pulmonary disease

目的了解老年慢性阻塞性肺疾病(COPD)病人并发社区获得性肺炎常见病原菌及其耐药性的情况,为临床治疗提供参考。方法对我院70例老年COPD并发社区获得性肺炎患者的合格痰标本进行痰培养及药敏试验,对结果进行统计。结果70例患者痰培养阳性者共有40例,共获得致病菌株42株,革兰阴性杆菌占55.0%,其中铜绿假单胞菌最多(22.5%),其次为肺炎克雷伯菌、大肠埃希菌。革兰阳性球菌以肺炎链球菌最多(17.5%),其次为溶血性链球菌及金黄色葡萄球菌。革兰阴性杆菌对三代头孢霉素耐药严重,对头孢他定、头孢哌酮/舒巴坦或碳青霉烯类的抗生素较敏感。而革兰阳性球菌对青霉素几乎全部耐药,未发现对万古霉素耐药。结论老年COPD患者并发社区获得性肺炎的患者常见致病菌以革兰阴性杆菌多见,且耐药严重,临床选择抗生素时应加以注意。

Objective To investigate the distribution and resistance to antibiotics of patients of community acquired pneumonia with chronic obstructive pulmonary disease. Methods Bacteria isolates and their resistance to antibiotics were taken on sputum spemcimen from seventy patients of community acquired pneumoniawith chronic obstructive pulmonary disease. Results 42 strains were identified from 70 sputum spemcimen： 55.0% was Gram-negative bacilli 40. 0% , and among them, the most was Pseudomonas acruginosa （22.5%）. For the Gram-positive cocci the most was strepto-coccus pneumoniae（ 17.5% ）. The results revealed that Gram - negative bacilli decreased susceptibility to third generation cephalosporins, but were sensitive to imipenem, and in somewhat lesser extent to Ceftazidime, cefoperazone-sulbactam. Grin-positive cocci showed high resistance to penicillin while found no resistance to vancomycin. Conclusion The main isolated pathogens from aged patients of community acquired pneumonia with chronic obstructive pulmonary disease are Gram-negative bacill,i and antimicrobial resistance is very common.