慢性阻塞性肺疾病急性加重期住院患者感染病原体特点

Characteristics of Infectious Pathogens in Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的通过检测各种感染病原体,揭示慢性阻塞性肺疾病急性加重期住院患者感染病原体特点,指导临床治疗。方法收集我院2015年4月至2016年6月收治的慢性阻塞性肺疾病急性加重期住院患者227例,根据感染病原体不同,患者分为A组(感染细菌)、B组(感染病毒)、C组(感染非典型病原体)、D组(感染真菌)、E组(未发现病原体)。统计各类病原体感染比例及具体分布情况、混合感染比例。结果 A、B、C、D、E组占慢性阻塞性肺疾病急性加重期住院患者的比例分别为57.3%、14.5%、11.0%、2.2%、36.1%。145例存在感染的患者,感染单一种类病原体占71.7%,混合感染占28.3%。B组、C组合并细菌感染的比例分别为72.7%、84%。感染细菌以铜绿假单胞菌、肺炎克雷伯杆菌最常见,分别占构成比的22.2%、19.4%。病毒感染以乙型流感病毒、甲型流感病毒、副流感病毒常见,分别占构成比的41.5%、24.6%、24.6%。非典型病原体感染主要为肺炎支原体感染。结论慢性阻塞性肺疾病急性加重期住院患者以细菌感染最多见,以革兰阴性菌为主。感染病毒或肺炎支原体的患者多合并细菌感染。

Objective Through the detection of a variety of infectious pathogens,to reveal the characteristics of infectious pathogens in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease, and to guide the clinical treat- ment. Methods A total of 227 hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease admitted to our hospital between April 2015 and June 2016 were collected and divided into group A（ infected bacteria） ,group B（ infected with virus）, group C （ infected with atypical pathogens ）, group D （ infected fungal ）, group E （ not found pathogens ）, according to the difference of infection pathogen. The proportion of infection and specific distribution of pathogens and the proportion of mixed infec- tion were counted. Results Group A,group B,group C,group D,and group E accounted for 57.3% ,14.5% ,11% ,2.2% ,and 36. 1% in hospitalized patients with exacerbations of chronic obstructive pulmonary disease, respectively. Among the 145 patients with infectious diseases,71.7% of patients were infected with single pathogens, and mixed infections accounted for 28. 3%. The proportion of group B, group C combined with bacterial infection was respectively 72. 7 %, 84%. The most common infectious bacte- ria were Pseudomonas aeruginosa and Klebsiella pneumoniae, accounting for 22. 2%, 19.4% of the constituent ratio, respectively. Viral infections were common with influenza B, influenza A, and parainfluenza viruses, accounting for 4t. 5% , 24.6% ,24.6% of the constituent ratio,respectively. Atypical infection was mainly caused by Mycoplasma pneumoniae infection. Conclusion In pa- tients with acute exacerbation of chronic obstructive pulmonary disease, bacterial infection isthe most common in hospitalized pa- tients,and gram negative bacteria are the main pathogens. Patients infected with the virus or Mycoplasma pneumoniae are more likely to have combined bacterial infections.