支气管扩张症感染患者急性加重期病原菌分布及耐药性分析

Distribution of pathogens in bronchiectasis patients in acute exacerbation stage and analysis of drug resistance

目的探讨支气管扩张症感染急性加重期患者的病原菌分布及其耐药性,以期为支气管扩张症的抗菌治疗提供更多的理论依据。方法将收治的188例支气管扩张症感染加重期患者进行病原菌及药物敏感试验检测。结果 188例患者痰液标本阳性96例,阳性率为51.06%,分离出菌株102株,其中革兰阴性菌74株占72.55%,革兰阳性菌28株占27.45%,首位是铜绿假单胞菌占31.37%,其次为流感嗜血菌占13.73%;肺炎克雷伯菌、大肠埃希菌对环丙沙星、左氧氟沙星、氨苄西林、头孢呋辛、头孢曲松的耐药率均>50.0%。结论支气管扩张症急性加重期患者细菌感染主要以革兰阴性杆菌为主,应根据细菌培养、药物敏感试验结果及治疗反应及时调整抗菌药物。

OBJECTIVE To investigate the distribution and drug resistance of pathogens in the acute exacerbation of bronchieetasis patients so as to provide theoretical basis for the antimicrobial treatment of bronchiectasis. METHODS A total of 188 cases of patients with acute exacerbation of bronehiectasis were divided into two groups according to the status of Pseudornonas aeruginosa infections, with 102 cases in the risk factor group and 86 cases in the non-risk factor group, then the pathogens were detected, and the drug susceptibility testing was performed. RESULTS Of 188 cases of patients, the sputum specimens were cultured positive in 96 cases with the positive rate of 51.06% ; totally 102 strains of pathogens were isolated, including 74 （72.55%） strains of gram-negative bacte- ria and 28 （27.45 % ） cases of gram-positive bacteria, among which the Pseudornonas aeruginosa （31.37 %） ranked the first place, followed by the Haernophilus influenzae （13.73%）% The drug resistance rates of the Klebsiella pneumoniae and Escherichia coli to ciprofloxacin, levofloxacin, ampicillin, cefuroxime, or ceftriaxone were more than 50.0 %. CONCLUSION The gram-negative bacilli are predominant among the pathogens causing infections in the acute exacerbation of bronchiectasis patients, it is necessary to choose broad spectrum antibiotics in accordance with the risk factors of P. aeruginosa infections and to adjust in a timely manner based on the bacterial culture and the drug susceptibility testing as well as the treatment response.