慢阻肺急性加重期患者呼吸道病原菌的构成情况及其耐药性研究

Study on the Composition of Respiratory Pathogenic Bacteria and their Drug Resistance in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:分析慢阻肺急性加重期患者呼吸道病原菌的构成情况及其耐药性研究。方法:选取2019年3月—2021年4月焦作煤业(集团)有限责任公司中央医院收治的86例慢阻肺急性加重期患者,均采集痰标本,行病原菌培养和药敏试验,分析病原菌构成情况和对抗菌药物耐药性。结果:86份痰标本中,共分离出98株病原菌,革兰阴性菌75株,占比76.53%,以铜绿假单胞菌(26.53%)、肺炎克雷伯菌(21.43%)为主;革兰阳性菌18株,占比18.37%,以金黄色葡萄球菌(8.16%)、表皮葡萄球菌(6.12%)为主;真菌5株,占比5.32%,以白色念珠菌(3.19%)为主;铜绿假单胞菌对复方新诺明、氨苄西林耐药率较高,对亚胺培南无耐药性;肺炎克雷伯菌对氨苄西林耐药率100.00%,对阿米卡星、亚胺培南无耐药性;金黄色葡萄球菌、表皮葡萄球菌对头孢西丁耐药率100.00%,二者均对万古霉素无耐药性。结论:慢阻肺急性加重期多为革兰阴性菌感染,其次为革兰阳性菌及真菌,临床应分析病原菌构成及耐药性,参照药敏试验结果,科学合理使用抗菌药物进行治疗,提高临床治疗效果。

Objective:To analyze the composition of respiratory pathogens and their drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods:86 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the hospital from March 2019 to April 2021 were selected,and all sputum specimens were collected for patho⁃genic bacteria culture and drug sensitivity test.The composition of pathogenic bacteria and resistance to antimicrobial drugs were analyzed.Results:A total of 98 pathogenic strains were isolated from 86 sputum specimens.Gram-negative bacteria were 75 strains,accounting for 76.53%,with Pseudomonas aeruginosa(26.53%)and Klebsiella pneumoniae(21.43%)predominating.There were 18 Gram-positive strains,accounting for 18.37%,dominated by Staphylococcus aureus(8.16%)and Staphylococcus epidermidis(6.12%).There were 5 strains of fungi,accounting for 5.32%,with Candida albicans(3.19%)predominating.Pseudomonas aeruginosa had a high resistance rate to cotrimoxazole and ampicillin,and no resistance to imipenem.Klebsiella pneumoniae was 100.00%resistant to ampicillin and was not resistant to amikacin and imipenem.Staphylococcus aureus and Staphylococcus epidermidis were 100.00%resistant to cefoxitin,and both were not resistant to vancomycin.Conclusion:The acute exacerbation of chronic obstructive pulmonary disease is mostly infected by gram-negative bacteria,followed by gram-positive bacteria and fungi.The clinic should analyze the composition and drug resistance of pathogenic bacteria,refer to the results of drug sensitivity test,scientifically and reasonably use antibacterial drugs for treatment,and improve the clinical treatment effect.