崇明地区151例高龄慢性阻塞性肺疾病急性加重患者痰标本的病原菌分布及药敏结果分析  

Analysis of Pathogen Distribution and Drug Sensitivity Results of Sputum Samples From 151 Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Chongming Area

作　　者：孙凯 周中华 郭志华 石月 马媛媛 熊洁 SUN Kai;ZHOU Zhonghua;GUO Zhihua;SHI Yue;MA Yuanyuan;XIONG Jie(Chongming Branch,Shanghai the Tenth People's Hospital,Shanghai 202157)

机构地区：[1]上海第十人民医院崇明分院,上海202157

出　　处：《智慧健康》2024年第7期18-22,共5页Smart Healthcare

基　　金：上海市崇明区科学技术委员会项目《崇明区慢性阻塞性肺疾病患者病原学分析及研究》(项目编号:CKY2020-07)。

摘　　要：目的 本研究旨在明确崇明地区高龄慢性阻塞性肺病急性加重(AECOPD)患者痰标本的病原菌分布及其药物敏感性,从而优化基层医院抗生素的应用。方法 选取2020年1月—2022年8月本院收治的151例AECOPD患者作为研究对象,收集人口统计学资料,留取痰标本进行细菌分离鉴定及药敏试验。结果151例菌株从患者痰标本中成功分离,其中革兰氏阴性菌147株(97.4%),革兰氏阳性菌4株(2.6%)。革兰氏阴性菌中主要的肺炎克雷伯菌(28.5%)、肺炎克雷伯菌亚种(22.5%)、大肠埃希菌(12.6%)、铜绿假单胞菌(12.6%)对常见药物都有较佳敏感性,不动杆菌属(4.6%)则耐药性高。革兰氏阳性菌对常见药物均具有较高敏感性。结论 崇明地区高龄AECOPD患者病原菌分布以革兰氏阴性菌,尤其是肺炎克雷伯菌及亚种、大肠埃希菌、铜绿假单胞菌为主,发生耐药少,宜选β内酰胺酶抑制剂、头孢菌素或氟喹诺酮类抗生素进行初始治疗。Objective To clarify pathogen distribution and drug sensitivity of sputum samples of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in Chongming area,and optimize application of antibiotics in grassroots hospitals.Methods The paper chose 151 AECOPD patients admitted to our hospital from January 2020 to August 2022 as research subjects,collected demographic data,sputum samples for bacterial isolation,identification,and drug sensitivity testing.Results 151 strains were successfully isolated from sputum samples of patients,including 147 Gram negative bacteria(97.4%) and 4 Gram positive bacteria(2.6%).Main Gram negative bacteria,including Klebsiella pneumoniae(28.5%),Klebsiella pneumoniae subspecies(22.5%),Escherichia coLI(12.6%),and Pseudomonas aeruginosa(12.6%),have good sensitivity to common drugs,while genus Acinetobacter(4.6%) has high resistance.Gram positive bacteria have high sensitivity to common drugs.Conclusion Distribution of pathogens of elderly AECOPD patients in Chongming area is mainly Gram negative bacteria,especially Klebsiella pneumoniae and its subspecies,Escherichia coli,and Pseudomonas aeruginosa,with less occurrence of drug resistance.Therefore,it is recommended to choose appropriate pathogen β Initial treatment with lactamase inhibitors,cephalosporins,or fluoroquinolone antibiotics.

关 键 词：慢性阻塞性肺疾病 病原菌 药物敏感度 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R563.9[医药卫生—临床医学]