医学研究与教育
醫學研究與教育
의학연구여교육
MEDICAL RESEARCH AND EDUCATION
2014年
4期
12-15
,共4页
AECOPD%病原菌%药敏分析
AECOPD%病原菌%藥敏分析
AECOPD%병원균%약민분석
AECOPD%pathogen%antimicrobial susceptibility
目的：探讨慢性阻塞性肺病急性加重期（AECOPD）患者下呼吸道感染时痰病原菌群的分布及药敏试验结果，为临床合理应用抗菌药物提供参考依据。方法对2012年1月至2013年6月呼吸科病房110例AECOPD住院患者痰细菌培养和药敏试验结果进行分析。结果110例AECOPD患者痰病原菌中，革兰氏阴性杆菌占50.69%，以铜绿假单胞菌、鲍曼不动杆菌、大肠埃希氏菌为主；真菌占39.33%，以白色念珠菌和曲霉菌为主；革兰氏阳性球菌占7.87%，以金黄色葡萄球菌、肺炎链球菌为主；2种以上病原菌混合感染占33.70%。细菌体外药敏试验发现：亚胺培南、美罗培南、头孢吡肟、头孢他啶、头孢哌酮舒巴坦、哌拉西林、哌拉西林他唑巴坦、左氧氟沙星、环丙沙星、氨曲南对大部分革兰阴性杆菌有较好敏感性，本组真菌对两性霉素、氟康唑、伊曲康唑、伏立康唑均敏感。万古霉素、利奈唑胺、替考拉宁、头孢呋辛、头孢噻肟钠、氯霉素对大部分革兰阳性球菌有较好敏感性。结论AECOPD分离的细菌以革兰氏阴性杆菌为主，真菌感染率较高，应引起高度重视，各病原菌对多种抗菌药物的耐药率有上升趋势，经验用药应选择3代、4代头孢菌素和含β内酰胺酶抑制剂的抗生素，重症患者需联合抗真菌药物。
目的：探討慢性阻塞性肺病急性加重期（AECOPD）患者下呼吸道感染時痰病原菌群的分佈及藥敏試驗結果，為臨床閤理應用抗菌藥物提供參攷依據。方法對2012年1月至2013年6月呼吸科病房110例AECOPD住院患者痰細菌培養和藥敏試驗結果進行分析。結果110例AECOPD患者痰病原菌中，革蘭氏陰性桿菌佔50.69%，以銅綠假單胞菌、鮑曼不動桿菌、大腸埃希氏菌為主；真菌佔39.33%，以白色唸珠菌和麯黴菌為主；革蘭氏暘性毬菌佔7.87%，以金黃色葡萄毬菌、肺炎鏈毬菌為主；2種以上病原菌混閤感染佔33.70%。細菌體外藥敏試驗髮現：亞胺培南、美囉培南、頭孢吡肟、頭孢他啶、頭孢哌酮舒巴坦、哌拉西林、哌拉西林他唑巴坦、左氧氟沙星、環丙沙星、氨麯南對大部分革蘭陰性桿菌有較好敏感性，本組真菌對兩性黴素、氟康唑、伊麯康唑、伏立康唑均敏感。萬古黴素、利奈唑胺、替攷拉寧、頭孢呋辛、頭孢噻肟鈉、氯黴素對大部分革蘭暘性毬菌有較好敏感性。結論AECOPD分離的細菌以革蘭氏陰性桿菌為主，真菌感染率較高，應引起高度重視，各病原菌對多種抗菌藥物的耐藥率有上升趨勢，經驗用藥應選擇3代、4代頭孢菌素和含β內酰胺酶抑製劑的抗生素，重癥患者需聯閤抗真菌藥物。
목적：탐토만성조새성폐병급성가중기（AECOPD）환자하호흡도감염시담병원균군적분포급약민시험결과，위림상합리응용항균약물제공삼고의거。방법대2012년1월지2013년6월호흡과병방110례AECOPD주원환자담세균배양화약민시험결과진행분석。결과110례AECOPD환자담병원균중，혁란씨음성간균점50.69%，이동록가단포균、포만불동간균、대장애희씨균위주；진균점39.33%，이백색념주균화곡매균위주；혁란씨양성구균점7.87%，이금황색포도구균、폐염련구균위주；2충이상병원균혼합감염점33.70%。세균체외약민시험발현：아알배남、미라배남、두포필우、두포타정、두포고동서파탄、고랍서림、고랍서림타서파탄、좌양불사성、배병사성、안곡남대대부분혁란음성간균유교호민감성，본조진균대량성매소、불강서、이곡강서、복립강서균민감。만고매소、리내서알、체고랍저、두포부신、두포새우납、록매소대대부분혁란양성구균유교호민감성。결론AECOPD분리적세균이혁란씨음성간균위주，진균감염솔교고，응인기고도중시，각병원균대다충항균약물적내약솔유상승추세，경험용약응선택3대、4대두포균소화함β내선알매억제제적항생소，중증환자수연합항진균약물。
Objective To analyze the distribution of pathogens tract and their drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The sputum samples of 110 AECOPD patients from our hospital and the pathogen species in all samples were tested. The drug sensitivity was determined. Results Of all the pathogens found in AECOPD patients, 50.69% were Gram-negative, 39.33% were epiphytes, 7.87 % were Gram-positive, 33.70% of the patients were co-infected by more than two pathogens. Among the Gram-negative bacilli, the main pathogens included Pseudomonas aeruginosa, Acinetobacter baumannii and Egypt hopes the fungus. Among the Gram-positive cocci, the main pathogens included Staphyloccus aureus and Streptococcus pneumoniae, The results of drug sensitivity test showed that most of the Gram-negative bacilli were more sensitive to imipenem, meropenem, cefepime, ceftazidime,cefoperazone shubatan, pipercillin, pipercillin and tazobactam, levolfoxacin, ciprolfoxacin and aztreonam. The epiphytes were highly sensitive to amphoteric enzyme, lfuconazol, itraconazole and voriconazole, while most of the Gram-positive cocci were more sensitive to vancomycin,linezolid,leicoplanin,cefuroxime,cefotaxime sodium and chloramphenicol. 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.
