合并支气管扩张的慢性阻塞性肺疾病患者病原菌谱及耐药性分析

Distribution and antibiotic resistance of pathogenic bacteria for patients with chronic obstructive pulmonary disease and bronchiectasis

目的分析合并支气管扩张的慢性阻塞性肺疾病(简称慢阻肺)患者病原菌分布及其耐药性情况,为临床治疗提供参考依据。方法回顾性分析230例合并支气管扩张的慢阻肺患者痰培养及药敏试验结果。结果230例合并支气管扩张的慢阻肺患者中,痰培养共分离出病原菌182株;其中革兰阴性杆菌145株(79.67%);革兰阳性球菌23株(12.64%);真菌14株(7.69%)。占比最高的前五位病原菌分别为:铜绿假单胞菌(31.32%)、肺炎克雷伯杆菌(17.58%)、大肠埃希菌(11.54%)、鲍曼不动杆菌(10.76%)和金黄色葡萄球菌(8.24%)。药敏试验结果显示绝大多数病原菌存在多重耐药性。结论合并支气管扩张的慢阻肺患者病原菌以革兰阴性杆菌为主,且绝大多数病原菌存在多重耐药性。定期监测病原菌的分布及耐药情况,为临床合理选择抗菌药物具有重要指导意义。

Objective To analyze the distribution and antibiotic resistance of pathogenic bacteria of patients with bronchiectasis complicated with chronic obstructive pulmonary disease(COPD),in order to provide reference for clinical treatment.Methods The results of sputum culture and drug sensitivity test in 230 patients with bronchiectasis complicated with COPD were retrospectively analyzed.Results A total of 182 strains of pathogenic bacteria were isolated in 230 patients,including 145 strains of Gram-negative bacilli(79.67%),23 strains of Gram-positive cocci(12.64%)and 14 strains of fungi(7.69%).The top five bacterial species were pseudomonas aeruginosa(31.32%),klebsiella pneumonia(17.58%),escherichia coli(11.54%),acinetobacter baumannii(10.76%)and staphylococcus aureus(8.24%).Drug sensitivity test showed that vast majority of bacteria had multiple drug resistance.Conclusion The pathogenic bacteria of bronchiectasis complicated with COPD patients are mainly Gram-negative bacilli,and the majority of bacteria has multiple drug resistance.Regular monitoring of the distribution and drug resistence of bacteria has important guiding significance for the rational selection of antimicrobial drugs.