老年中-重度COPD患者下呼吸道感染菌株的耐药性分析

Analysis on Bacterial Drug Resistance of Lower Respiratory Infection in Geriatric Patients with Mild-severe COPD

目的:探讨老年中-重度COPD患者下呼吸道感染菌株的分布及耐药性,为临床合理用药提供依据。方法:随机选择我院2006年4月～2008年1月收治的老年中-重度COPD患者合并下呼吸道感染152例,对检验分离获得的178株细菌以纸片扩散法(KB法)行药敏测定分析。结果:178株细菌中主要致病菌依次为铜绿假单胞菌、不动杆菌、肺炎克雷伯菌、阴沟杆菌、粪肠球菌、金黄色葡萄球菌居分离菌前6位。13.8%的患者合并有真菌感染,药敏结果表明:亚胺培南、头孢他啶、头孢哌酮/舒巴坦、阿米卡星为大多数细菌敏感,但对青霉素类及头孢菌素类抗生素耐药性明显增强。结论:老年中-重度COPD患者下呼吸道感染以G-菌为主,其中铜绿假单胞菌、不动杆菌、肺炎克雷伯菌为多,部分患者合并真菌感染。

Objective： To investigate bacterial disposition and drug resistance in lower respiratory tract on geriatric patients with mild- severechronic obstructive pulmonary emphysema （COPD）. Methods：From Apr 2006 to Jan 2008,152 geriatric patients with mild-severe COPD were chosen randomly in hospital. The bacterial drug sensitivity of 178 strains isolated from these patients were analyzed by KB methods. Results： Of 178 strains, The main pathogenic bacteria were Pseudomonas aeruginosa, Immobility bacillus ,K.peneumoniae Bacillus,cloacae, Enterobaeter cloacae and Staphylococcus aureus in the first six top, ratio of patients who complicated with fungous infection was 13.8%,most of those bacteria were sensitive with Imipenem ＆ Cilastatin, Ceftazidime, Cefoperazone and Sulbactam Sodium and Amikaein Sulfate. Drug resistance with penicilline and cefo increased significantly. Conclusion： The grain negative bacteria were main bacteria on geriatric patients with COPD, Pseudomonas aeruginosa, Immobility bacillus and K.peneumoniae was most, same patients was complicated by fungous infection.