慢性阻塞性肺疾病患者病原菌分布及耐药性分析

Pathogen distribution and analysis of drug resistance in patient with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病患者的病原菌分布及耐药性分析,为临床合理用药提供依据。方法选取2008年2月至2010年2月收治的120例慢性阻塞性肺疾病患者为研究对象,患者均伴有呼吸道感染,对其痰液进行细菌培养,采用药物敏感(药敏)一体化试剂盒进行药敏试验,并分析细菌的耐药性。结果分离出的188例菌株中革兰阴性菌最多,有126株,占67.0%,其中以铜绿假单胞菌最多,占27.1%;革兰阳性菌54株,占28.7%,其中以金黄色葡萄球菌最多,占12.2%;真菌8株,占4.3%。药敏试验发现,对革兰阴性菌有效的抗生素为亚胺培南、阿莫西林、头孢他啶;对革兰阳性菌有效的抗生素为亚胺培南、头孢他啶、万古霉素。结论慢性阻塞性肺疾病感染患者以革兰阴性菌为主,且耐药率较高,需不断检测病原菌的变化及药物药敏情况,选择合适抗生素。

Objective To investigate the pathogen distribution and analysis of drug resistance in patient with chronic obstructive pulmonary disease,and to provide the evidence for clinical use of drugs. Methods One hundred and twenty patients with chronic obstructive pulmonary disease from February 2008 to February 2010 were selected,all patients were associated with respiratory tract infections,bacterial culture was done for their sputum,drug sensitive test was done using sensitivity integration kit and bacteria resistance was analysed. Results There were 126 stains of Gram-negative bacteria in 188 cases of isolated strains（67.0%）,in which Pseudomonas aeruginosa was the most,accounting for 27.1%.There were 54 strains of Gram-positive bacteria（28.7%）,in which Staphylococcus aureus was the most,accounting for 12.2 %.There were 8 strains of fungi,accounting for 4.3%.Drug sensitive test showed that effective antibiotics against Gram-negative bacteria were imipenem,amoxicillin and ceftazidime and effective antibiotics against Gram-positive bacteria were imipenem,ceftazidime and vancomycin. Conclusion Patients with chronic obstructive pulmonary disease infected with Gram-negative bacteria dominated,and its drug resistance rate is higher,drug susceptibility changes in endemic species and medicine sensitive situation were tested constantly and to select the appropriate antibiotics.