AECOPD病原菌分布及耐药性分析  

Analysis of distribution and drug resistance of bacteria in acute exacerbation of chronic obstructive pulmonary disease

作　　者：张金松[1] 茅敏华[1] 姜觉如[1] 

机构地区：[1]启东市人民医院,江苏启东226200

出　　处：《临床肺科杂志》2011年第5期695-696,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析慢性阻塞性肺疾病急性发作期患者痰标本检出的病原菌分布及耐药性，为临床合理应用抗菌药物提供参考依据。方法对我院呼吸科病房2009年1月～2010年6月AECOPD患者痰标本分离确认的82株病原菌构成及耐药性进行统计分析。结果共分离出82株病原菌，革兰阴性菌为主，占73．2％（60株），其中以铜绿假单胞菌22％（18株），肺炎克雷伯菌18．3％（15株），阴沟肠杆菌11％（9株），大肠埃希菌7．3％（6株）为主要致病菌；革兰阳性菌占20．7％（17株），以凝固酶阴性葡萄球菌9．7％（8株），金黄色葡萄球菌7．3％（6株），肺炎链球菌3．7％（3株）为主；真菌占6．1％（5株）。药敏结果显示大多数革兰阴性杆菌对亚胺培南、哌拉西林／他唑巴坦、头孢哌酮／舒巴坦、头孢他啶、头孢吡肟、阿米卡星较敏感。结论我院AECOPD患者的病原菌构成以革兰阴性杆菌为主，有多重耐药现象，合理的经验性抗感染治疗应根据病原学和耐药性监测结果。Objective Analyze the distribution and drug resistance of the bacteria in the sputum specimen of patients with chronic obstructive pulmonary disease during acute exacerbation. Methods We analysd the data of 82 confirmed strains for their constitution and drug resistance from the sputum specimen of patients with AECOPD from January, 2009 to -June, 2010 in the respiratory department of our hospital. Results Totally, 82 strains were gram-negative bacteria, which accounted for the 73.2% ; Among which Pscudomonas aeruginosa, which made up 22% （18 strains）, klebsiella pneumoniae 18.3% （15 strains）, Enterobacter cloacae 11% （9 strains）, Escherichia coli 7.3% （6 strains） were the major pahogenic bacteria. The gram positive bacteria accounted for 20. 7% （ 17 strains）, which were mainly made up of coagulase negative staphylococci （9 strains, 9. 7% ） , Staphylococci aureus （7.3% , 6 strians） , strepto- cocci pneumoniae （3.7% ,3 strains） ; Fungi accounted for 6. 1% （5 strains）. Drug resistance results indicated that most bacteria were rather sensative to hnipenem, Piperacillin/Tazobactam, Cefoperazone/Sulbactam, Ceftazidime , Cefepime, Amikacin. Conclusion The pathogenic bacteria in patients with AECOPD in oar hospital were mainly composed of gram negative bacilli. The reasonable and experiential anti-infective therapy should be consistent with the results of etiologic and drug-resistant study.

关 键 词：慢性阻塞性肺疾病 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]