慢性阻塞性肺疾病并发呼吸机相关性肺炎患者的痰培养菌种分布和细菌耐药情况分析

Distribution of Sputum Culture Bacteria and Analysis of Bacterial Resistance in Patients with Chronic Obstructive Pulmonary Disease and Ventilator-associated Pneumonia

目的分析慢性阻塞性肺疾病并发呼吸机相关性肺炎患者的痰培养菌种分布和细菌耐药情况。方法 150例研究对象均为方便选取该院2015年1月—2017年5月期间该院收治的慢性阻塞性肺疾病并发呼吸机相关性肺炎患者,将患者入院24h内、出现肺炎情况后的痰液标本进行痰培养和药敏试验分析,观察两组痰培养结果及细菌耐药情况。结果 150例患者总计培养了300份标本,分离出致病菌222株,阳性率为74.00%;入院时患者标本阳性率为62.67%,出现肺炎后标本阳性率为85.33%,两组比较差异有统计学意义(χ2=5.325,P<0.05)。从药敏试验结果来看,革兰阴性菌中,铜绿假单细胞最容易发生耐药情况,且其对氨苄西林耐药性为100.00%;鲍曼不动杆菌对头孢哌酮/舒巴坦、亚胺培南和美罗培南比较耐药,肺炎克雷伯杆菌对谭青霉素类的敏感性较好。结论慢性阻塞性肺疾病并发呼吸机相关性肺炎的致病菌主要是革兰阴性菌,对抗生素的耐药率高,因此控制院内感染,选择合适的药物是减少呼吸机相关性肺炎的关键。

Objective This paper tries to analyze the distribution of sputum culture bacteria and drug resistance in patients with chronic obstructive pulmonary disease complicated with ventilator-associated pneumonia.Methods 150 patients with chronic obstructive pulmonary disease(COPD)complicated with ventilator-associated pneumonia who were admitted to this hospital from January 2015 to May 2017 were convenient selected.The patients were admitted to hospital within 24 h,the occurrence of sputum sputum after pneumonia and sputum culture drug susceptibility test analysis,two groups of sputum culture results and bacterial resistance were observed.Results A total of 300 specimens were cultured in 150 patients,222 strains were isolated,the positive rate was 74.00%;the positive rate of patients at admission was 62.67%,the positive rate of specimens after pneumonia was 85.33%,the difference was statistically Significance(χ2=5.325,P<0.05).From the point of view of drug susceptibility test results,gram-negative bacteria,the most susceptible to copper-leaf pseudocapsules,and its resistance to ampicillin,was 100.00%;Acinetobacter baumannii cefoperazone Ketone/sulbactam,imipenem and meropenem are more resistant,and Klebsiella pneumoniae is more sensitive to tamoxifen.Conclusion Chronic obstructive pulmonary disease associated with ventilator-associated pneumonia pathogens are mainly Gram-negative bacteria,high resistance to antibiotics,so the control of nosocomial infections,to select the appropriate drug is to reduce ventilator-associated pneumonia.