慢性阻塞性肺疾病患者下呼吸道感染病原体分布及对抗菌药物的耐药性研究

Study on the pathogen distribution of lower respiratory tract infection in patients with chronic obstructive pulmonary disease and their resistance to antibiotics

目的探讨慢性阻塞性肺疾病患者下呼吸道感染病原体分布及抗菌药物的耐药性,以提升患者临床用药合理性。方法选取2019年1月至2020年12月本院接收的100例慢性阻塞性肺疾病患者作为研究对象,取患者下呼吸道分泌物实施细菌培养与药敏试验,并分析患者的痰培养结果与抗菌药物敏感性。结果患者病原体78株,革兰氏阴性菌、革兰氏阳性菌、真菌占比分别为80.77%、11.54%、7.69%。铜绿假单胞菌对头孢他啶、环丙沙星、氨曲南、左氧氟沙星、头孢他啶具有较高耐药性;鲍曼不动杆菌各类抗菌药物均具有一定耐药性。肺炎链球菌对红霉素、青霉素耐药性较高;金黄色葡萄球菌对苯唑西林、青霉素、红霉素、莫西沙星、克林霉素、左氧氟沙星耐药性均较高;白假丝酵母菌对氟康唑耐药性为25.00%。结论革兰氏阴性菌是慢性阻塞性肺疾病患者下呼吸道感染的主要病原体,其具有较高耐药性,故在患者接受治疗时,医师应从患者实际病情出发,结合药敏试验结果,为患者提供更好的治疗方案。

Objective To investigate the pathogen distribution of lower respiratory tract infection and antibiotic resistance in patients with chronic obstructive pulmonary disease,in order to improve the rationality of clinical drug use in patients.Methods 100 patients with chronic obstructive pulmonary disease admitted by our hospital from January 2019 to December 2020 were selected as the research subjects,take their lower respiratory tract secretions for bacterial culture and drug sensitivity test,and conduct in-depth analysis of the sputum culture results and antibiotic sensitivity of the patients.Results There were 78 pathogens in the patient.Gram-negative bacteria,Gram-positive bacteria,and fungi accounted for 80.77%,11.54%,and 7.69%,respectively.Pseudomonas aeruginosa had high resistance to ceftazidine,ciprofloxacin,amtrannan,levofloxacin and ceftazidine;acinetobacter baumannii has some resistance to all kinds of antibiotics.Streptococcus pneumoniae had high resistance to erythromycin and penicillin;staphylococcus aureus had high resistance to benzoxicillin,penicillin,erythromycin,moxifloxacin,clindamycin and levofloxacin.The resistance of Candida albicans to fluconazole was 25.00%.Conclusion Gram-negative bacteria are the main pathogen of lower respiratory tract infection in patients with chronic obstructive pulmonary disease,and have high drug resistance,when patients receive treatment,doctors should start from the actual condition of patients and combine the results of drug sensitivity test to provide better treatment plan for patients.