支气管扩张症继发感染患者的病原菌及耐药性分析  

Pathogen distribution and drug resistance analysis of bronchiectasis patients with secondary infection

作　　者：潘丽娟[1] 毛毅敏[1] 孙瑜霞[1] 朱迎伟[1] 王向迎 PAN Li-juan MAO Yi-min SUN Yu-xia ZHU Ying-wei WANG Xiang-ying(The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan 471003, China)

机构地区：[1]河南科技大学第一附属医院呼吸与危重症医学科,河南洛阳471003

出　　处：《中华医院感染学杂志》2017年第7期1528-1530,1538,共4页Chinese Journal of Nosocomiology

摘　　要：目的观察支气管扩张症继发感染患者的病原菌分布及耐药性,为临床合理选择抗菌药物提供依据。方法选取2007年3月-2016年3月支气管扩张症继发感染患者107例痰液进行病原菌分离、培养鉴定,采用K-B纸片法进行药敏试验分析。结果共分离出113株病原菌,以革兰阴性菌为主,共85株占75.2%;铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌是主要革兰阴性菌,分别占23.0%、16.8%和13.3%,对青霉素、氨苄西林、头孢唑林耐药率>70.0%;铜绿假单胞菌对哌拉西林/他唑巴坦、妥布霉素、阿米卡星和亚胺培南等耐药率<10.0%;大肠埃希菌对哌拉西林/他唑巴坦、亚胺培南、阿米卡星和头孢吡肟等耐药率<20.0%;肺炎克雷伯菌对哌拉西林/他唑巴坦、亚胺培南、阿米卡星等耐药率<20.0%。结论支气管扩张症继发感染患者以革兰阴性菌为主,耐药现象较为严重,临床应根据药敏试验结果合理应用抗菌药物,防止耐药现象进一步加重。OBJECTIVE To observe the pathogen distribution and drug resistance of patients with bronchiectasis a- cute exacerbation infection, so as to provide clinical basis for reasonable choice of antimicrobial drugs. METHODS From Mar. 2007 to Mar. 2016, 107 cases of sputum of patients with bronehiectasis acute exacerbation infection were selected, the pathogens were isolated and cultured, and drug resistance was tested with K-B method. RESULTS From 107 cases of patients with bronchiectasis acute exacerbation infection, 113 strains of pathogenic bacteria were isolated, of which gram-negative bacteria （85 strains） were the most common bacteria, accounting for 75.2%. Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneurnoniae were the main gram-negative bacteria, accounting for 23.0%, 16.8% and 13.3%, and the resistant rates to penicillin, arnpicillin and cefazolin were all higher than 70%. The resistant rates of P. aeruginosa to piperacillin/tazobactam, tobramycin, amikacin and imipenem were all lower than 10%. The resistant rates of E. coli to piperacillin/tazobactam, imipenem, ami- kacin and cefepime were all lower than 20%. The resistant rates of K. pneumoniae to piperacillin / tazobactam, imipenem, and amikacin were all lower than 20%. CONCLUSION Bronchiectasis acute exacerbation infection pa- tients are mainly infected with gram-negative bacteria, and drug resistance is serious, which should rationally use antibacterial drugs according to susceptibility test results, so as to prevent further aggravated drug resistance.

关 键 词：支气管扩张症 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]