慢性阻塞性肺疾病急性加重期患者痰标本病原菌分布特点及耐药性分析  

A study on bacterial distribution and resistance of acute chronic obstrustive pulmonary disease

作　　者：闫薇[1] 许建英[1] 王淑峰[2] 李浩[2] 

机构地区：[1]山西医科大学第一医院呼吸科,030001 [2]山西医科大学第一医院检验科,030001

出　　处：《山西医药杂志（上半月）》2008年第5期396-398,共3页Shanxi Medical Journal

基　　金：山西省卫生厅科技攻关计划基金资助项目(200506)

摘　　要：目的分析慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者病原菌的分布特点及其对常用抗菌药物的敏感性和耐药性。方法从2004—2006年我院呼吸内科AECOPD患者的痰标本中分离致病菌521株,采用纸片扩散法(Kirby-Bauer法),按NCCLS标准判定敏感菌株并做药敏分析。结果常见病原菌为肺炎链球菌(28.8%)、铜绿假单胞杆菌(9.8%)、凝固酶阴性的葡萄球菌(8.1%)、鲍曼不动杆菌(6.1%)、大肠杆菌(3.3%)、嗜麦芽窄食单胞菌(2.3%)及金黄色葡萄球菌(1.3%)。药敏结果示:肺炎链球菌、凝固酶阴性的葡萄球菌及金黄色葡萄球菌对青霉素的耐药率达100%,对万古霉素、替考拉宁的敏感率达100%。铜绿假单胞杆菌、鲍曼不动杆菌和大肠杆菌对氨苄西林、复方磺胺甲口恶唑的耐药率均达100%,但对亚胺培南的敏感率在83.3%以上。大肠杆菌和肺炎克雷伯杆菌对亚胺培南的敏感率为100%。结论AECOPD患者痰分离细菌对常用抗菌药物耐药情况严重,临床应加强药敏测定,合理应用抗菌药物,减少细菌耐药性的产生。Objective To analyze the distributive characteristics, antimicrobial sensitivity and antimicrobial resistance of bacterium isolates from patients with AEODPD. Methods Five hundred and twenty-one clinical phlegm specimens were isolated from 2004 to 2006 and bacterial susceptibility test was carried out by Kirby-Bauer method according to NCCLS standards. Results Major pathogens in wards of respiratory disease include Pneumococcus （28.8%）, Pseudomonas aeruginosa （9.8%）, Coagulase-negative staphylococci （8.1%）, Acinetobacter baumannii （6.1% ）, Escherichia colil （3,3 % ）, Stenotrophomonas maltophilia （2.3 % ） and Staphylococcus aureus （ 1.3 % ）. The result of bacterial susceptibility test showed that drug resistance rate of Pneumococcus, Staphylococcus aureus and Coagulase-negative staphylococci to Penicillin is 100 %, the rate of sentivity to Vancomycine and Teicoplanin is 100 %. Pseudomonas aeruginosa, Acinetobacter baumannii and Escherichia coli for ampicillin and Compound Sulfamethoxazole is 100%, but the sensitivity rate for Imipenem is more than 83.3%. The sensitive rate of Escherichia coli, Stenotrophomonas maltophilia and Klebsiella pneumoniae to Imipenem is 100%. Conclusion The drug resistance of bacterium isolated form patients with AEODPD is serious. It is suggested that there is an urgent need to enhance drug sensitive test and use antibiotics reasonable in order to prevent the creation and diffusion of drug resistant strain.

关 键 词：肺疾病 慢性阻塞性 抗药性 细菌 微生物敏感性试验 

分 类 号：R563.9[医药卫生—呼吸系统] R446.5[医药卫生—内科学]