CAJ | 학술논문

目的：探讨慢性阻塞性肺疾病急性加重期( AECOPD)的病原菌分布和耐药性。方法收集柳州多家医院2012年2月至2014年6月期间呼吸内科的AECOPD患者805例，详细记录入组患者的临床资料，分析AECOPD患者的病原菌分布及耐药特点。结果805例AECOPD患者中分离出病原菌482例，共分离病原菌602株，其中革兰氏阴性菌430株，占71．5%，革兰氏阳性菌97株，占16．1%，真菌75株，占12．5%；铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌居前3位，分别占20．3%、18．3%和13．8%；肺炎克雷伯菌和大肠埃希菌对哌拉西林耐药率均>80．0%，大肠埃希菌对头孢哌酮、头孢曲松、环丙沙星、左氧氟沙星耐药率较高，均>50．0%。结论 AECOPD病原菌以革兰阴性杆菌为主，治疗应根据病原菌及药敏试验结果指导，临床合理选用抗菌药物。
목적：탐토만성조새성폐질병급성가중기( AECOPD)적병원균분포화내약성。방법수집류주다가의원2012년2월지2014년6월기간호흡내과적AECOPD환자805례，상세기록입조환자적림상자료，분석AECOPD환자적병원균분포급내약특점。결과805례AECOPD환자중분리출병원균482례，공분리병원균602주，기중혁란씨음성균430주，점71．5%，혁란씨양성균97주，점16．1%，진균75주，점12．5%；동록가단포균、폐염극뢰백균、대장애희균거전3위，분별점20．3%、18．3%화13．8%；폐염극뢰백균화대장애희균대고랍서림내약솔균>80．0%，대장애희균대두포고동、두포곡송、배병사성、좌양불사성내약솔교고，균>50．0%。결론 AECOPD병원균이혁란음성간균위주，치료응근거병원균급약민시험결과지도，림상합리선용항균약물。
Objective To discuss the pathogenic bacteria distribution and drug resistance in AECOPD pa-tients. Methods The clinical data of 805 AECOPD patients were reviewed to analyze their pathogenic bacteria distribution and drug resistance characteristics. Results 482 cases of pathogenic bacteria were isolated, which ob-tained 602 strains of pathogenic bacteria. There were 97 strains of gram-positive bacteria (16. 1%), 430 strains of gram-negative bacteria (71. 5%) and 75 strains of fungus (12. 5%). The most bacteria was pseudomonas aerugino-sa, followed by klebsiella pneumoniae and escherichia coli (20. 3%, 18. 3% and 20. 3% respectively). Klebsiella pneumoniae and escherichia coli were highly resistant to piperacillin ( >80. 0%) , Escherichia coli was highly resist-ant to cefoperazone, ceftriaxone, ciprofloxacin, levofloxacin ( >50. 0%) . Conclusion The main pathogen of AE-COPD is gram-negative bacilli, and the anti-biotics should be rationally chosen based on drug sensitivity test results.