慢性阻塞性肺疾病急性加重期下呼吸道感染细菌特点及耐药性分析

Analysis of bacterial characteristics and drug resistance of lower respiratory tract infection in acute exacerbation stage of chronic obstructive pulmonary disease

目的了解慢性阻塞性肺疾病急性加重期（AECOPD）患者下呼吸道感染中的细菌分布特点及耐药情况分析。方法对我院2011年7月至2014年6月住院的256例AECOPD患者进行痰培养，细菌药物敏感试验。结果根据2011年GOLD指南将256例COPD患者分为A、B、C、D4组，结果256例AECOPD患者中共有132例患者痰培养阳性，阳性率51．56％，共分离出164株菌株，其中G＋球菌：肺炎链球菌9株，金黄色葡萄球菌30株，其中MRSA7株，葡萄球菌13株。G杆菌：铜绿假单胞菌41株，肺炎克雷伯杆菌15株，大肠埃希菌i6株，鲍曼不动杆菌16株，嗜麦芽假单胞菌12株。部分为多重耐药菌，其中发现6例痰找抗酸杆菌阳性。结论C、D组患者易感染G～杆菌，且部分为多重耐药菌，并且需警惕个别合并感染结核杆菌，加强细菌耐药监测有利于抗生素的合理应用。

Objective To investigate the acute exacerbation chronic obstructive pulmonary disease （AECOPD） analysis of bacterial distribution and drug resistance in patients with lower respiratory tract infection. Methods Two hundred and fifty-six cases of AECOPD patients in our hospital from 2011 July to 2014 June were sputum culture,drug sensitive test. Results According to the 2011 GOLD guidelines for 256 patients with COPD were divided into four group of A, B, C, D, the results of 256 cases of AECOPD patients, 132 cases of patients with sputum culture positive, the positive rate of 51.56% ,a total of 164 strains were isolated, including 9 strains of Streptococcus pneumoniae.. G＋ aureus, 30 strains of Staphylococcus aureus, which MRSA 7 strains, Staphylococcus aureus 13 strain. Coli G-：41 strains of Pseudomonas aeruginosa,Klebsiella pneumoniae 15 strains, 16 strains of Escherichia coli, 16 strains of Bauman Aeinetobacter, Pseudomonas maltophilia strain 12. Part of multi drug resistant bacteria, which found that 6 cases of sputum for acid fast bacilli positive. Conclusions C,D group were easily infected G- coil, and part of multi drug resistant bacteria, and the need to guard against the individual combined infection of Mycobaeterium tuberculosis, the reasonable application of strengthening the surveillance of bacterial resistance in favor of antibiotics.