东南国防医药
東南國防醫藥
동남국방의약
JOURNAL OF SOUTHEAST CHINA NATIONAL DEFENCE MEDICAL SCIENCE
2014年
5期
499-501
,共3页
于海容%孟浩%许柳柳%李香彭
于海容%孟浩%許柳柳%李香彭
우해용%맹호%허류류%리향팽
慢性阻塞性肺疾病,急性发作期%病原菌%药敏分析
慢性阻塞性肺疾病,急性髮作期%病原菌%藥敏分析
만성조새성폐질병,급성발작기%병원균%약민분석
chronic obstructive pulmonary disease,acute exacerbation%etiology%drug sensitivity test
目的：了解淮海地区慢性阻塞性肺疾病（ chronic obstructive pulmonary disease，COPD）急性加重期合并下呼吸道感染患者的病原菌特点及药敏分析，以指导临床合理用药。方法回顾性分析2010年1月-2013年12月住院的560例COPD急性加重（ acute exacerbation chronic obstructive pulmonary disease，AECOPD）合并下呼吸道感染的痰液细菌培养结果及药敏分析。结果560例中分离到病原菌480株，G-杆菌296株，占61．67％，依次是铜绿假单胞菌、肺炎克雷伯杆菌、大肠埃希菌、洋葱假单胞菌、鲍曼不动杆菌。 G＋球菌106株，占22．08％，主要是金黄色葡萄球菌、溶血性葡萄球菌、化脓性链球菌。真菌78株，占16．25％，主要是白色念珠菌。药敏结果显示G-杆菌对碳青霉烯类、氨基糖甙类、头孢哌酮舒巴坦钠较敏感；G＋球菌对万古霉素、利奈唑胺、头孢哌酮舒巴坦钠敏感；真菌主要对氟康唑敏感。结论 AECOPD患者下呼吸道感染病原菌以G-杆菌为主，易合并真菌感染，根据药敏结果合理应用抗生素是治疗的关键。
目的：瞭解淮海地區慢性阻塞性肺疾病（ chronic obstructive pulmonary disease，COPD）急性加重期閤併下呼吸道感染患者的病原菌特點及藥敏分析，以指導臨床閤理用藥。方法迴顧性分析2010年1月-2013年12月住院的560例COPD急性加重（ acute exacerbation chronic obstructive pulmonary disease，AECOPD）閤併下呼吸道感染的痰液細菌培養結果及藥敏分析。結果560例中分離到病原菌480株，G-桿菌296株，佔61．67％，依次是銅綠假單胞菌、肺炎剋雷伯桿菌、大腸埃希菌、洋蔥假單胞菌、鮑曼不動桿菌。 G＋毬菌106株，佔22．08％，主要是金黃色葡萄毬菌、溶血性葡萄毬菌、化膿性鏈毬菌。真菌78株，佔16．25％，主要是白色唸珠菌。藥敏結果顯示G-桿菌對碳青黴烯類、氨基糖甙類、頭孢哌酮舒巴坦鈉較敏感；G＋毬菌對萬古黴素、利奈唑胺、頭孢哌酮舒巴坦鈉敏感；真菌主要對氟康唑敏感。結論 AECOPD患者下呼吸道感染病原菌以G-桿菌為主，易閤併真菌感染，根據藥敏結果閤理應用抗生素是治療的關鍵。
목적：료해회해지구만성조새성폐질병（ chronic obstructive pulmonary disease，COPD）급성가중기합병하호흡도감염환자적병원균특점급약민분석，이지도림상합리용약。방법회고성분석2010년1월-2013년12월주원적560례COPD급성가중（ acute exacerbation chronic obstructive pulmonary disease，AECOPD）합병하호흡도감염적담액세균배양결과급약민분석。결과560례중분리도병원균480주，G-간균296주，점61．67％，의차시동록가단포균、폐염극뢰백간균、대장애희균、양총가단포균、포만불동간균。 G＋구균106주，점22．08％，주요시금황색포도구균、용혈성포도구균、화농성련구균。진균78주，점16．25％，주요시백색념주균。약민결과현시G-간균대탄청매희류、안기당대류、두포고동서파탄납교민감；G＋구균대만고매소、리내서알、두포고동서파탄납민감；진균주요대불강서민감。결론 AECOPD환자하호흡도감염병원균이G-간균위주，역합병진균감염，근거약민결과합리응용항생소시치료적관건。
Objective To provide the rational application of antibiotics for the clinical treatment by analyzing acute exacerba-tion chronic obstructive pulmonary disease( AECOPD) patients with sputum culture and sensitivity results in Huaihai region.Methods The clinical data of 560 cases with lower respiratory infection of AECOPD were obtained from January 2010 to December 2013 and analyzed retrospectively.Results 480 sputum pathogens of 560 cases were isolated.Gram-negative bacilli were found in 296 (61.67%),including concluding pseudomonas aeruginosa,klebsiella pneumoniae,escherichia coli,pseudomonas cepacia,acinetobacter baumannii and so on.Gram-positive aureus were detected in 106 (22.08%),composed with staphylococcus aureus,haemolyticus staph-ylococcus and streptococcus pyogenes.Fungus pathogens were occurred in 78 (16.25%),most of which were candida albicans.The main Gram-negative bacilli were sensitive to carbapenems,aminoglycoside,cefoperazone sodium and sulbactam sodium.The main Gram-positive aureus were sensitive to vancomycin,linezolid,cefoperazone sodium and sulbactam sodium.Fungus was sensitive to fluconazole. Conclusion Gram-negative bacilli are the main pathogenic bacterium and fungal infection is followed usually.The key of treatment is to use antibiotics reasonably according to the results of drug sensitive experiment.
