慢性阻塞性肺病急性加重期下呼吸道病原菌感染及药敏结果分析  

Infection and drug resistance of pathogens in lower respiratory tract of patients with acute explosion chronic obstructive pulmonary disease

作　　者：赵坚 任涛 

机构地区：[1]仙居县人民医院,浙江仙居317300

出　　处：《中国微生态学杂志》2011年第4期361-362,364,共3页Chinese Journal of Microecology

摘　　要：目的探讨慢性阻塞性肺病急性加重期(AECOPD)下呼吸道病原菌群的分布及分析药敏试验结果。方法对仙居县人民医院呼吸病房收治的128例AECOPD患者的痰细菌培养和药敏试验结果进行分析。结果 AECOPD患者感染的病原菌中,革兰阴性杆菌占61.95%,以铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌为主;革兰阳性球菌占21.43%,以金黄色葡萄球菌、粪肠球菌为主;真菌占14.88%;2种以上病原菌混合感染占20.31%。体外药敏试验发现:亚胺培南对大部分革兰阴性杆菌有较好敏感性,万古霉素对大部分革兰阳性球菌有较好敏感性,检出的真菌对氟胞嘧啶、两性霉素、氟康唑、依曲康唑均保持较高敏感性。结论 AECOPD患者下呼吸道感染病原菌以革兰阴性杆菌为主,真菌感染率和混合感染率较高,应引起重视,应根据药敏结果合理选用抗菌药物。Objective To analyze the distribution of pathogens in respiratory tract and their drug resistance in patients with acute explosion chronic obstructive pulmonary disease（AECOPD）.Method The sputum samples of 128 AECOPD patients from our hospital and the pathogen species in all samples were tested.The drug sensitivity was determined.Result Of all the pathogens found in AECOPD patients,61.95% were Gram-negative,21.43% were Gram-positive,and 14.88% were epiphytes.20.31% of the patients were co-infected by more than two pathogens.Among the Gram-negative bacilli,the main pathogens included Pseudomonas aeruginosa,Klebsiella pneumoniae and Acinetobacter baumannii.Among the Gram-positive cocci,the main pathogens included Staphyloccus aureus and Enterococcus faecalis.The results of drug sensitivity test showed that most of the Gram-negative bacilli were more sensitive to imipenem,while most of the Gram-positive cocci were more sensitive to vancomycin.The epiphytes were highly sensitive to fluorocytosine,amphotericin,fluconazol and itraconazole.Conclusion Gram-negative bacilli are predominant in lower respiratory tract in AECOPD patients.The ratio of mycotic infection and mixed infection are high,to which more attention should be paid.Drug resistance should be considered adequately to be used appropriately.

关 键 词：慢性阻塞性肺病急性加重期 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]