支气管扩张合并支气管哮喘患者支气管肺泡灌洗液病原菌培养及药敏状况研究

Cultivation of Bronchoalveolar Ravage Fluid and Sensitivity of Bronchiectasis Combined with Bronchial Asthma

目的：对支气管扩张合并支气管哮喘患者支气管肺泡灌洗液病原菌培养及药敏状况展开分析,实现多药耐药医院感染的有效预防与控制。方法：随机选取2010年9月~2013年8月期间收治的50例支气管扩张症合并支气管哮喘患者,对50例患者支气管肺泡灌洗液标本进行病原学检测及药敏试验,并对临床感染资料及病原菌耐药性进行统计学分析。结果：50例支气管扩张症合并支气管哮喘患者支气管肺泡灌洗液培养阳性率为30例,60.0%,共分离出48株细菌。其中,革兰阳性球菌5株,占分离菌的10.4%;革兰阴性杆菌41株,占分离菌的85.4%;真菌2株,占分离菌的4.2%。41株革兰阴性杆菌对抗菌药物的耐药性分别为：复方新诺明73.1%,阿米卡星22.0%,环丙沙星14.6%,头孢曲松48.8%,头孢噻肟41.5%,头孢哌酮19.5%,头孢他啶20.7%,头孢他啶/舒巴坦12.1%,头孢吡肟22.0%,庆大霉素17.1%,阿莫西林/克拉维酸41.5%,哌拉西林/他唑巴坦19.5%。结论：铜绿假单胞菌是支气管扩张合并哮喘患者感染中的常见病原菌,医务人员要结合病原菌高耐药率、高分离阳性率的特征,合理运用抗菌药物控制传播。

Objective： To analyze the bronchoalveolar ravage fluid culture and drug susceptibility of patients with bronchiectasis and bronchial asthma in order to achieve the effective prevention and control of multidrug-resistant for hospital infections. Methods： A retrospective analysis was carried on by bacterial identification and susceptibility about the clinical data of 50 patients with bronchial asthma who were enrolled in our hospital from September 2010 to August 2013. The bronchoalveolar ravage fluid samples were detected, the susceptibility was tested, and the clinical information and pathogen infection resistance were analyzed statistically. Results： Among the 50 cases with the bronchial asthma who were treated by the bronchoalveolar ravage fluid, 60.0% were cultured positively with the isolated 48 bacteria, five were Gram-positive coccid（10.4%）, 41 were Gram-negative bacilli（85.4%）, two were fungi（4.2%）. 41 Gram-negative bacilli that resistant to the antimicrobial drugs were as follows： cotrimoxazole （73.1%）, alizarin （22.0%）, ciprofloxacin （14.6%）, ceflriaxone（48.8%）, cefotaxime（41.5%）, cephalosporin＇s risperidone（19.5%）, ceftazidime（20.7%）, ceftazidime/sulfate（12.1%）, caffeine（22.0%）, gentamicin（17.1%）, amoxicillin/clavulanic acid（41.5%）, piperacillin/tazobactam（19.5%）. Conclusions： It is suggested that the common bacteria is the pseudomonas aerations for the patients with bronchiectasis and bronchial asthma that requires the medical staff take responsibility of controlling the drug-resistant and spread on the basis of acquiring the high resistance to the pathogen and the rate of separation.