4年中AECOPD病人痰培养及药敏结果比较

Comparison of sputum culture and drug susceptibility of AECOPD patients in 4 years

目的了解我院呼吸科AECOPD住院病人痰培养结果及对抗生素耐药率的变化情况。方法收集2013-2014年与2015-2016年我院呼吸科AECOPD住院病人痰培养结果及药敏资料进行比较与分析。结果 (1)病原菌分布情况比较:2015-2016年痰细菌培养阳性率较2013-2014年明显下降,痰真菌培养阳性率明显升高,差异有统计学意义(P<0.05)。(2)药敏结果分析:革兰阴性杆菌对三、四代头孢的耐药率有增高趋势,对β-内酰胺酶抑制剂以及碳青霉烯类抗生素均较敏感。2015-2016年肺炎克雷伯杆菌对头孢他啶的耐药率比2013-2014年明显升高,差异有统计学意义(P<0.05)。鲍曼不动杆菌对抗生素的耐药较为普遍。结论革兰氏阴性菌为痰培养阳性病例中的主要病原菌,真菌感染也呈上升趋势。

Objective To investigate the Results of sputum culture and the rate of antibiotic resistance in AECOPD inpatients. Methods The Results of sputum culture and susceptibility data of AECOPD inpatients from2013-2014 and 2015-2016 were collected and compared. Results( 1) The distribution Results of pathogens showed that the positive rate of sputum culture from 2015-2016 was significantly lower than that from 2013-2014,and the positive rate of sputum culture increased significantly( P < 0. 05).( 2) Drug susceptibility analysis showed gram-negative bacilli had a increase trend on the three or four generations of cephalosporins resistance rate,and more sensitive to β-lactamase inhibitors and carbapenem antibiotics. The resistance rate of Klebsiella pneumoniae to ceftazidime was significantly higher from 2015-2016 than that from 2013-2016( P < 0. 05). Acinetobacter baumannii resistance to antibiotics was more common. Conclusion Gram-negative bacteria are the main pathogens in sputum culture positive cases,and fungal infection is also increasing.