1940例慢性阻塞性肺病患者感染的病原菌特点及其耐药性分析  

Analysis of drug sensitivity of bacterial infection in 1 940 COPD patients

作　　者：赵苏瑛[1] 李岷[1] 李克涓[1] 

机构地区：[1]江苏省中医院检验科微生物室,南京210009

出　　处：《微生物与感染》2008年第2期73-74,83,共3页Journal of Microbes and Infections

摘　　要：目的分析慢性阻塞性肺病(COPD)患者感染的病原菌组成情况及其耐药性与院内耐药性比较。方法采用VITEK全自动微生物鉴定系统鉴定病原菌,按美国临床实验室标准化委员会(NCCLS)的纸片扩散法进行耐药性、超广谱β内酰胺酶(ESBLs)及耐甲氧西林葡萄球菌(MRS)检测,统计分析采用Whonet5.4软件进行。结果培养出的革兰阴性菌中肺炎克雷伯、铜绿假单胞菌及大肠埃希菌占前3位,革兰阳性菌中以葡萄球菌和肠球菌为主,ESBL、MRS检出率分别为78.5%与76.1%,Fisher确切概率计算法所得革兰阴性菌的耐药率明显高于全院患者所感染革兰阴性菌的平均水平。结论COPD患者感染以革兰阴性菌较为多见,且耐药率明显高于全院水平,ESBL、MRS检出率高,提示感染患者细菌的高耐药性。Objective To understand the drug sensitivity of bacterial infection in COPD patients relative to the drug sensitivity with bacterial infection in other patient populations in our hospital. Methods Bacteria were identified by the automated VITEK system, their drug sensitivity was examined with K-B method according to National Committee of Clinical Laboratory Standard （NCCLS）, USA, plus detection of extended-spectrum （-lactamases （ESBLs） and methicillin-resistant Staphylococcus aureus （MRSA）. Data were analyzed by computer statistic software Whonet 5.4.Results In the order of frequency of infection, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli were responsible for the top three bacterial infections among COPD patients. Gram-positive bacteria were mostly consisted of Staphylococcus and Enterococcus. ESBLs and MRSA represented 78.5 % and 76.1%, respectively. Fisher＇ s probability analysis showed that the percentage of drug resistant Gram-negative bacteria was higher than other patient populations in our hospital. Conclusion In COPD patients, Gram-negative bacteria are more frequent in COPD patients and have higher drug resistance than other patient populations as shown by the higher rate of ESBLs and MRSA detection.

关 键 词：慢性阻塞性肺病 病原学 耐药性 

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