安徽医科大学学报
安徽醫科大學學報
안휘의과대학학보
ACTA UNIVERSITY MEDICINALIS ANHUI
2015年
1期
101-104
,共4页
慢性阻塞性肺疾病急性加重期%病原学%耐药性%抗生素
慢性阻塞性肺疾病急性加重期%病原學%耐藥性%抗生素
만성조새성폐질병급성가중기%병원학%내약성%항생소
acute exacerbation of chronic obstructive pulmonary disease%pathogenic bacteria%drug resistance%anti-biotics
目的：了解慢性阻塞性肺疾病急性加重期( AECO-PD)患者细菌感染的病原菌分布特点及耐药性情况。方法回顾性分析近6年来安徽医科大学第一附属医院老年呼吸内科740例AECOPD患者的痰培养及药敏结果。结果740例患者的痰培养阳性率为39．1%。314株阳性菌中革兰阴性细菌196株，占62．4%，常见菌依次为铜绿假单胞菌、鲍曼溶血不动杆菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌、大肠埃希菌。革兰阳性细菌21株，占总数6．7%，常见菌依次为溶血葡萄球菌、肺炎链球菌、金黄色葡萄球菌。真菌97株，占总数30．9%，最常见的是白色假丝酵母菌。革兰阴性细菌普遍对第3代头孢菌素、青霉素类抗生素耐药，对氨基糖苷类中度耐药，亚胺培南耐药性较低。革兰阳性细菌对大部分抗生素均有不同程度耐药，仅对利奈唑胺、万古霉素保持较高敏感性。真菌对抗真菌药普遍较敏感。结论 AECOPD 患者细菌感染多以革兰阴性细菌为主，耐药性普遍。加强病原菌检测、掌握病原菌分布及耐药情况，为临床合理使用抗生素提供依据，从而减缓耐药菌的产生与传播。
目的：瞭解慢性阻塞性肺疾病急性加重期( AECO-PD)患者細菌感染的病原菌分佈特點及耐藥性情況。方法迴顧性分析近6年來安徽醫科大學第一附屬醫院老年呼吸內科740例AECOPD患者的痰培養及藥敏結果。結果740例患者的痰培養暘性率為39．1%。314株暘性菌中革蘭陰性細菌196株，佔62．4%，常見菌依次為銅綠假單胞菌、鮑曼溶血不動桿菌、肺炎剋雷伯菌、嗜麥芽窄食單胞菌、大腸埃希菌。革蘭暘性細菌21株，佔總數6．7%，常見菌依次為溶血葡萄毬菌、肺炎鏈毬菌、金黃色葡萄毬菌。真菌97株，佔總數30．9%，最常見的是白色假絲酵母菌。革蘭陰性細菌普遍對第3代頭孢菌素、青黴素類抗生素耐藥，對氨基糖苷類中度耐藥，亞胺培南耐藥性較低。革蘭暘性細菌對大部分抗生素均有不同程度耐藥，僅對利奈唑胺、萬古黴素保持較高敏感性。真菌對抗真菌藥普遍較敏感。結論 AECOPD 患者細菌感染多以革蘭陰性細菌為主，耐藥性普遍。加彊病原菌檢測、掌握病原菌分佈及耐藥情況，為臨床閤理使用抗生素提供依據，從而減緩耐藥菌的產生與傳播。
목적：료해만성조새성폐질병급성가중기( AECO-PD)환자세균감염적병원균분포특점급내약성정황。방법회고성분석근6년래안휘의과대학제일부속의원노년호흡내과740례AECOPD환자적담배양급약민결과。결과740례환자적담배양양성솔위39．1%。314주양성균중혁란음성세균196주，점62．4%，상견균의차위동록가단포균、포만용혈불동간균、폐염극뢰백균、기맥아착식단포균、대장애희균。혁란양성세균21주，점총수6．7%，상견균의차위용혈포도구균、폐염련구균、금황색포도구균。진균97주，점총수30．9%，최상견적시백색가사효모균。혁란음성세균보편대제3대두포균소、청매소류항생소내약，대안기당감류중도내약，아알배남내약성교저。혁란양성세균대대부분항생소균유불동정도내약，부대리내서알、만고매소보지교고민감성。진균대항진균약보편교민감。결론 AECOPD 환자세균감염다이혁란음성세균위주，내약성보편。가강병원균검측、장악병원균분포급내약정황，위림상합리사용항생소제공의거，종이감완내약균적산생여전파。
Objective To understand the pathogenic bacteria distribution and drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The retrospective analysis was per-formed in the sputum culturs and drug resistance results of 740 patients with AECOPD. Results The positive rate of bacterial infection was 39. 1%. Among them, gram-negative bacteria were 196 strains (62. 4%), gram-positive bacteria 21 strains (6. 7%), and fungi 97 strains(30. 9%). The main kinds of gram-negative bacteria were Pseud-omonas aeruginasa, Acinetobacter baumannii,Klebsiella pneumoniae,Stenotrophomonas maltophilia and Escherichia-coli. Staphylococcus haemolyticus, Streptococcus pneumoniae and Staphylococcus aureus were the most frequent gram-positive bacteria. The major fungi was Candida albicans. Gram-negative bacteria showed high resistance to the third-generation cephalosporins,penicillins, moderate resistance to aminoglycosides,low resistance to imipenem. Gram-positive bacteria were resistant to many kinds of antibiotics, but they were responsive to linezolid and vancomycin. Fungi showed high sensitivity to antifungal agents. Conclusion The pathogens of AECOPD mainly are gram-nega-tive bacteria with a high drug resistance rate. To monitor pathogenic bacteria is conducive to master the pathogens distribution, drug resistance and provide the basis of rational use of antibiotics,which can slow down the emergence and spread of resistant bacteria.
