慢性阻塞性肺疾病急性加重期患者痰病原微生物检出状况及3年演变

Detection of sputum pathogenic microorganisms in patients with acute exacerbation of chronic obstructive pulmonary disease and its 3-year evolution

目的了解慢性阻塞性肺疾病急性加重期(AECOPD)患者的常见致病菌分布及其动态演变,并分析其相关影响因素。方法收集767例AECOPD患者初期送检痰标本,均做痰培养细菌学检验,排除同一患者相同部位的重复菌株,根据检验结果分析病原菌分布情况。结果从767例患者的痰标本中共检出408株病原菌,病原菌检出率为53.19%;分别为2013年143株、2014年126株、2015年139株。其中,革兰阴性菌共计217株,各年度分别为67、67、83株;革兰阳性菌共计42株,各年度分别为8、16、18株;真菌149株,各年度分别为68、43、38株。结论 AECOPD患者治疗过程中应紧密结合当地流行病学资料,常规开展相关病原学检测,了解病原微生物学的动态变化,结合具体情况对抗菌药物作出合理应用,以避免耐药性的产生。

Objective To understande the distribution and dynamic evolution of common pathogens in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）,and analyze its influencing factors.Methods The sputum samples were collected from 767 patients with AECOPD at early stage,and bacteriological examination was carried out in sputum culture.The repetitive strains in the same part of the same patient were excluded,and the distribution of pathogens was analyzed according to the test results.Results A total of 408 pathogens were detected from the sputum specimens of 767 patients,with pathogen detection rate as 53.19%,and there were 143 strains in 2013,126 strains in 2014 and 139 strains in 2015 respectively.There were 217 strains of gram negative bacteria,with 67,67 and 83 strains in each year,42 strains of gram-positive bacteria,with 8,16 and 18 strains in each year,and 149 strains of fungus,with 68,43 and 38 stains in each year.Conclusion For the treatment of AECOPD patients,local epidemiological data should be closely combined with and routine pathogenic tests should be carried out to understand the dynamic changes of pathogenic microbiology.The rational use of antimicrobial drugs should be combined with the specific circumstances to avoid the emergence of drug resistance.