慢性阻塞性肺疾病急性加重期患者痰培养结果分析

Analysis of results of sputum culture in patients with acute exacerbations of chronic obstructive pulmonary disease

目的:了解慢性阻塞性肺疾病急性发作期患者的常见致病菌及其耐药情况,为临床抗生素的使用提供依据。方法:对在我院住院的慢性阻塞性肺疾病急性加重期患者的痰培养及药敏结果进行分析。结果:从208例患者的痰标本中共检出144株病原菌,其中,革兰阴性菌75株,主要为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌;革兰阳性菌39株,以金黄色葡萄球菌、肺炎链球菌、粪肠球菌为主;白色念珠菌30株。细菌药敏试验发现,革兰阴性菌对大多数抗菌药物耐药严重,对碳青霉烯类抗生素耐药率低;金黄色葡萄球菌总体对青霉素耐药率高,未发现对万古霉素耐药的菌株。结论:慢性阻塞性肺疾病急性加重期患者的病原菌耐药率有明显上升趋势,应该加强病原菌检测,合理使用抗生素,减少耐药菌株的产生。

Objective： To investigate the pathogenic characteristics in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）, so as to provide valuable data for choosing antibiotic therapy. Methods： The data of bacteriological sputum culture and sensitivity test results were analyzed in AECOPD patients in our hospital. Results： Among 208 patients with AECOPD, 144 pathogens were isolated, including 75 gram-negativ.e bacillis, mainly including Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia, 39 gram-positive bacillis were isolated, mainly including Staphylococcus aureus, Streptococcus pneumonia and Enterococcus faecalis; 30 Candida albicans were isolated. The drug resistance rate of gram-negative bacillus against most antibiotics was high, but it was relatively low for carbopen- em antibiotics. The drug resistance rate of the Staphylococcus aureus to penicillin was high, vancomycin resistant Staphylococcus aureus was not found. Conclusion： Drug resistance rate of AECOPD patients shows an obviously upward tendency. The correct detection for pathogenic organisms is beneficial to instruct clinical doctors for reasonable application of antibiotics and reducing the production of drug resistance strains.