慢阻肺并发肺部感染患者痰液病原菌分布及耐药性分析

Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Patients with Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Infection

目的分析慢阻肺并发肺部感染患者痰液病原菌分布及耐药性。方法选取2016年1月—2018年10月该院收治的慢阻肺并发肺部感染患者1140份,搜集患者痰液标本,进行菌种鉴定及药敏试验。结果1140份痰液标本中检出病原菌共1296株,其中革兰阴性杆菌占71.99%,革兰阳性球菌占27.01%,真菌占1.00%。革兰阴性杆菌中检出比例较高的分别为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌及鲍曼不动杆菌,革兰阳性球菌中金黄色葡萄球菌占比最高,其次为屎肠球菌。铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌及鲍曼不动杆菌对头孢呋辛和氨苄西林的耐药率明显高于其他药物,金黄色葡萄球菌对多种药物均呈现出较高的耐药率,屎肠球菌对氨苄西林的耐药率明显高于其他药物,上述6种病原菌对万古霉素均未呈现出耐药性。结论革兰阴性杆菌是引起慢阻肺患者发生肺部感染的常见致病菌,其实是革兰阳性球菌;革兰阴性杆菌对头孢呋辛和氨苄西林高度耐药,革兰阳性球菌对氨苄西林高度耐药,临床应根据病原学检查结果及药敏实验,合理应用抗菌药物。

Objective To analysis of distribution and drug resistance of pathogenic bacteria in patients with chronic obstructive pulmonary disease complicated with pulmonary infection.Methods 1140 patients with chronic obstructive pulmonary disease complicated with pulmonary infection in our hospital were selected from January 2016 to October 2018,the sputum samples were collected,performed strain identification and drug sensitivity test.Results A total of 1296 pathogens were detected in 1140 sputum samples,of which gram-negative bacilli accounted for 71.99%,gram-positive cocci accounted for 27.01%and fungi accounted for 1.00%.The higher proportions of gram-negative bacilli were pseudomonas aeruginosa,escherichia coli,klebsiella pneumoniae and acinetobacter baumannii,and staphylococcus aureus accounted for the highest proportion of gram-positive cocci,than enterococcus faecium.The re-sistance rates of pseudomonas aeruginosa,escherichia coli,klebsiella pneumoniae and acinetobacter baumannii to cefuroxime and ampicillin were significantly higher than other drugs,staphylococcus aureus showed a high resistance rate to a variety of drugs,the re-sistance rate of enterococcus faecium to ampicillin was significantly higher than other drugs,and the above 6 pathogens showed no re-sistance to vancomycin.Conclusion Gram-negative bacilli are common pathogens causing pulmonary infection in patients with chronic obstructive pulmonary disease,the gram-positive cocci;gram-negative bacilli are highly resistant to cefuroxime and ampicillin,and gram-positive cocci are highly resistant to ampicillin,the clinical should be rational application of antibacterial drugs based on the results of pathogens examination and drug sensitivity test.