老年慢性阻塞性肺疾病患者肺部感染病原菌与肠道定植菌的关系  

Relationship between pathogenic bacteria of pulmonary infection and intestinal flora in elderly patients with COPD

作　　者：张珊珊 马微芬 ZHANG Shan-shan;MA Wei-fen(Department of Respiratory M edicine,Beilun District People's Hospital,Beilun District,Ningbo,Zhejiang 313800,China)

机构地区：[1]宁波市北仑区人民医院呼吸内科,浙江315800

出　　处：《中国微生态学杂志》2021年第4期432-435,共4页Chinese Journal of Microecology

摘　　要：目的探讨老年慢性阻塞性肺疾病(COPD)患者肺部感染病原菌与肠道定植菌的关系,为后续研究提供参考。方法选择2018年7月至2019年7月我院呼吸内科收治的60例COPD患者作为研究对象,根据是否合并肺部感染将患者分为感染组(n=38)和未感染组(n=22)。收集患者痰和粪便标本进行细菌培养,比较两组患者痰和粪便细菌检出情况,并对痰培养及粪便培养结果进行直线相关回归分析。结果感染组患者痰标本中铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌及大肠埃希菌检出率高于未感染组(均P<0.05)。感染组患者粪便标本中铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、阴沟肠杆菌、肠球菌、金黄色葡萄球菌检出率高于未感染组,肺炎链球菌检出率低于未感染组(均P<0.05)。感染组患者粪便中各细菌检出率与痰培养细菌检出率呈正相关(r=0.745,P=0.009)。未感染组患者粪便中各细菌检出率与痰培养细菌检出率无显著相关性。结论老年COPD合并肺部感染患者病原菌与肠道定植菌具有一定相关性,临床治疗中应重视COPD患者肠道微生态平衡以降低肺部感染发生率。Objective To explore the relationship between pathogenic bacteria of pulmonary infection and intestinal flora in elderly patients with chronic obstructive pulmonary disease(COPD) and provide a reference for the following study. Methods A total of 60 COPD patients admitted to the respiratory department of our hospital from July 2018 to July 2019 were selected. According to the presence or absence of pulmonary infection, the patients were divided into infection group(n=38) or noninfection group(n=22). Samples of sputum and feces were collected for bacterial culture;The detection rates and composition of bacteria were compared between groups. The results of sputum culture and fecal culture were analyzed by linear regression. Results The detection rates of Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli in the sputum samples in infection group were higher than those in noninfection group(all P<0.05). The detection rates of Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter cloacae, Enterococcus and Staphylococcus aureus in the fecal samples in infection group were higher, while that of Streptococcus pneumonia was lower than those in noninfection group, respectively(all P<0.05). The detection rates of bacteria in fecal culture in the infection group were positively correlated with those in sputum culture(r=0.745, P=0.009), while no significant correlation was found in the detection rates of bacteria between fecal culture and sputum culture in noninfection group. Conclusion The pathogenic bacteria of pulmonary infection are closely related to intestinal flora in elderly COPD patients with pulmonary infection, so the microecological balance in digestive tract in patients with COPD should be closely monitored to reduce the incidence of pulmonary infection.

关 键 词：慢性阻塞性肺疾病 肺部感染 肠道定植菌 相关性 

分 类 号：R563.1[医药卫生—呼吸系统]