老年慢性阻塞性肺病细菌耐药性和药物敏感性分析

Analysis of Older Chronic Obstructive Pulmonary Disease Bacteria Resistant and Drug Sensitivity

目的:了解湖南地区慢性阻塞性肺病(COPD)老年患者痰培养的细菌耐药性和药物敏感性,为临床应用抗菌药物提供科学依据。方法:对笔者所在医院148例COPD急性发作期住院患者痰进行细菌培养,并对其进行药敏试验,分析病原菌对抗菌药物的耐药性和药物敏感性。结果:培养阳性患者中革兰阴性菌感染占69.54%(铜绿假单胞菌、肺炎克雷伯菌及大肠埃希菌占前3位),革兰阳性菌感染占23.65%,以葡萄球菌属的分离率最高。真菌感染占6.76%。大多数革兰阴性杆菌对亚胺培南、舒巴坦/头孢哌酮敏感,其次是氨基糖苷类;革兰阳性菌属对万古霉素的敏感,白色念珠菌对氟康唑敏感。结论:对于COPD急性加重的老年患者,应加强对患者的耐药性监测,根据痰培养结果和药物敏感性试验,可对患者提供恰当的抗感染经验性治疗,减少细菌耐药性产生及菌群失调,提高治疗有效性。

Objective:To study bacterial resistance and drug sensitivity by sputum cultures of chronic obstructive pulmonary disease(COPD) elderly patients in the hunan area,provide a scientific basis for the clinical application of antibacterial drugs.Methods:To analyze on the bacteria resistant and the drug sensitivities in 148 elderly chronic obstructive pulmonary disease patients was conducted by the sputum culture and drug sensitive test.Results:Training with positive gram-negative bacterium was infection accounted for 69.54%(Pseudomonas aeruginosa,klebsiella pneumonia and escherichia coli before of three).Gram-positive bacterium infection accounted for 23.65%,with staphylococcus separation of the highest rate.Fungal infection accounted for 6.76%.Most gram-negative bacteria to imipenem,cefoperazone-sulbactam sensitivity,second was aminoglycoside;Gram-positive bacterium was sensitive to vancomycin,candida albicans was sensitive to fluconazole.Conclusion:For elderly patients with acute exacerbations of COPD,should strengthen resistance monitoring of patients,according to the results and sputum cultures drug sensitivity test,to provide proper fight infection in patients with empirical treatment,reduce resistance and dysbacteriosis of bacteria,improve the treatment efficiency.