慢性阻塞性肺疾病急性加重期下呼吸道感染病原学检测及耐药分析

Investigation of etiology and drug resistance in lower respiratory tract infection patients with chronic obstructive pulmonary disease during acute exacerbation

目的探讨慢性阻塞性肺疾病（COPD）患者急性加重期下呼吸道感染的病原菌分布情况及其耐药特点,为临床合理使用抗生素治疗提供依据。方法回顾性分析本院2008年1~12月呼吸科92例COPD患者急性加重期下呼吸道病原学和细菌耐药性特点。结果共培养阳性菌101株,革兰阴性细菌占主导地位,主要包括铜绿假单胞菌（31.24%）、大肠埃希菌（24.56%）、鲍曼不动杆菌（14.85%）;革兰阳性菌中金黄色葡萄球菌（9.78%）、表皮葡萄球菌（4.72.%）;白色假丝酵母菌（6.75%）;部分致病菌呈多重耐药。结论 COPD急性加重期下呼吸道感染病原菌以革兰阴性菌占优势,部分致病菌呈多重耐药,临床应合理使用抗生素防止细菌耐药。

Objective To investigate the characteristics of the distribution and drug resistance of bacteria in lower respiratory tract infection patients with chronic obstructive pulmonary disease during acute exacerbation.Methods The characteristics of distribution and drug resistance of bacteria in 92 patients in respiratory department were retrospectively analyzed.Results The Gram-negative bacteria are the most frequent pathogenic agents,including Pseudomonas aeruginosa（31.24%）,Escherichia coli（24.56%） and baumanii（14.85%）.And Staphylococcus aureus was one of the most frequent Gram-positive bacteria（9.78%）.The drug resistance of pathogenic bacteria was generally stepped up.Conclusion Gram-negative bacteria are the main pathogenic bacteria in lower respiratory tract infection in patients with chronic obstructive pulmonary disease during acute exacerbation.,There is a multi-drug resistance to the bacteria,and antibiotics should be used reasonablely.