老年慢性阻塞性肺疾病合并肺部感染患者的微生物检验结果及药敏实验临床分析  

Clinical analysis of microbiological test results and drug sensitivity test in elderly patients with chronic obstructive pulmonary disease complicated with pulmonary infection

作　　者：黄燕文[1] 罗胜强[1] 岑美婷[1] Huang Yanwen;Luo Shengqiang;Cen Meiting(Guangzhou First People's Hospital,Guangzhou,Guangdong 510000,China)

机构地区：[1]广州市第一人民医院,广东广州510000

出　　处：《首都食品与医药》2024年第16期77-80,共4页Capital Food Medicine

摘　　要：目的分析老年慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)合并肺部感染患者的微生物检验结果及药敏实验结果.方法选择2023年1-12月广州市第一人民医院接诊的60例COPD合并肺部感染患者作为研究对象,统计COPD合并肺部感染患者微生物检验结果,分析主要病原微生物对临床常用抗菌药物的耐药性情况.结果60例COPD合并肺部感染患者痰液标本中检测出病原微生物67株,包括革兰阴性菌[41株(61.19%)]、革兰阳性菌[23株(34.33%)]和真菌[3株(4.48%)].41株革兰阴性菌中,针对大肠埃希菌耐药性较高的抗菌药物为复方磺胺(90.00%)和氨苄西林(80.00%);针对铜绿假单胞菌耐药性较高的抗菌药物为呋喃妥因(100.00%)、氨苄西林(88.89%)、头孢呋辛酯(88.89%)、头孢呋辛钠(88.89%)及头孢曲松(77.78%);针对肺炎克雷伯菌耐药性较高的抗菌药物为氨苄西林(100.00%).23株革兰阳性菌中,针对金黄色葡萄球菌耐药性较高的抗菌药物为克林霉素(87.50%)、青霉素(87.50%)、红霉素(75.00%);针对肺炎链球菌耐药性较高的抗菌药物为青霉素(83.33%)、红霉素(83.33%).结论导致老年COPD患者发生肺部感染的主要病原微生物为革兰阴性菌,不同的抗菌药物产生耐药性的菌种也不一样,临床医师治疗患者时应根据药敏实验结果合理选用抗菌药物.Objective To analyze the elderly with Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary diseases(COPD)by Pulmonary infection in patients with microbial test results and drug susceptibility test results.Methods A total of 60 COPD patients with pulmonary infection admitted to our hospital from January to December 2023 were selected as the research objects.The microbiological test results of COPD patients with pulmonary infection were counted,and the drug resistance of main pathogenic microorganisms to commonly used antibiotics in clinical practice was analyzed.Results 67 strains of pathogenic microorganisms were detected in sputum samples of 60 COPD patients with pulmonary infection,including gram-negative bacteria[41 strains(61.19%)],Gram-positive bacteria[23 strains(34.33%)]and fungi[3 strains(4.48%)].Among the 41 gram-negative strains,the antimicrobial agents with high resistance to Escherichia coli were cotrimosulfamide(90.00%)and ampicillin(80.00%).The antimicrobial agents with high resistance against Pseudomonas aeruginosa were furantoin(100.00%),ampicillin(88.89%),cefuroxime axetil(88.89%),cefuroxime sodium(88.89%)and ceftriaxone(77.78%).The antimicrobial drug with high resistance against Klebsiella pneumoniae was ampicillin(100.00%).Among the 23 strains of gram-positive bacteria,the antimicrobial drugs with high resistance to Staphylococcus aureus were clindamycin(87.50%),penicillin(87.50%)and erythromycin(75.00%).The antibiotics with high resistance to Streptococcus pneumoniae were penicillin(83.33%)and erythromycin(83.33%).Conclusion The main pathogenic microorganisms that cause pulmonary infection in the elderly with COPD are gram-negative bacteria,and the bacteria that have resistance to different antibacterial drugs are different.Clinicians should rationally select antibacterial drugs according to the results of drug sensitivity test when treating patients.

关 键 词：COPD 肺部感染 痰液标本 微生物培养 药敏实验 耐药性 

分 类 号：R446.1[医药卫生—诊断学]