当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
17期
81-82
,共2页
慢性阻塞肺疾病%急性加重%药物耐药性%病原菌
慢性阻塞肺疾病%急性加重%藥物耐藥性%病原菌
만성조새폐질병%급성가중%약물내약성%병원균
Chronic obstructive pulmonary disease%Acute exacerbation%Distribution and drug resistance%Pathogens
目的：研究慢性阻塞性肺疾病急性加重期患者（AE-COPD）下呼吸道病原菌的分布及耐药性，为临床应合理用药物提供参考。方法回顾性分析AE-COPD住院患者痰标本细菌培养及药敏结果，对142例患者下呼吸道痰标本分离的病原菌用VITEK-32全自动细菌鉴定仪进行鉴定，采用K-B纸片法进行体外药物敏感试验。结果共分离出病原菌142例，革兰阴性菌、革兰阳性菌、真菌分别占70.4%、19.7%、9.9%；革兰阴性菌中以铜绿假单胞菌、大肠埃氏菌、肺炎克雷伯杆菌、鲍曼不动杆菌多见，分别占31.7%、11.9%、9.9%、9.9%；革兰阳性菌以金黄色葡萄球菌为主，占8.5%；真菌以白色念珠菌为主，占8.5%，革兰阴性菌对头孢哌酮/舒巴坦、阿米卡星、亚胺培南最敏感，革兰阳性菌对万古霉素和替考拉宁最敏感。结论 AE-COPD患者病原菌以革兰阴性杆菌为主，耐药率偏高，依据病原菌分布及耐药性监测结果指导抗菌药物的合理应用，是治疗AE-COPD的重要手段。
目的：研究慢性阻塞性肺疾病急性加重期患者（AE-COPD）下呼吸道病原菌的分佈及耐藥性，為臨床應閤理用藥物提供參攷。方法迴顧性分析AE-COPD住院患者痰標本細菌培養及藥敏結果，對142例患者下呼吸道痰標本分離的病原菌用VITEK-32全自動細菌鑒定儀進行鑒定，採用K-B紙片法進行體外藥物敏感試驗。結果共分離齣病原菌142例，革蘭陰性菌、革蘭暘性菌、真菌分彆佔70.4%、19.7%、9.9%；革蘭陰性菌中以銅綠假單胞菌、大腸埃氏菌、肺炎剋雷伯桿菌、鮑曼不動桿菌多見，分彆佔31.7%、11.9%、9.9%、9.9%；革蘭暘性菌以金黃色葡萄毬菌為主，佔8.5%；真菌以白色唸珠菌為主，佔8.5%，革蘭陰性菌對頭孢哌酮/舒巴坦、阿米卡星、亞胺培南最敏感，革蘭暘性菌對萬古黴素和替攷拉寧最敏感。結論 AE-COPD患者病原菌以革蘭陰性桿菌為主，耐藥率偏高，依據病原菌分佈及耐藥性鑑測結果指導抗菌藥物的閤理應用，是治療AE-COPD的重要手段。
목적：연구만성조새성폐질병급성가중기환자（AE-COPD）하호흡도병원균적분포급내약성，위림상응합리용약물제공삼고。방법회고성분석AE-COPD주원환자담표본세균배양급약민결과，대142례환자하호흡도담표본분리적병원균용VITEK-32전자동세균감정의진행감정，채용K-B지편법진행체외약물민감시험。결과공분리출병원균142례，혁란음성균、혁란양성균、진균분별점70.4%、19.7%、9.9%；혁란음성균중이동록가단포균、대장애씨균、폐염극뢰백간균、포만불동간균다견，분별점31.7%、11.9%、9.9%、9.9%；혁란양성균이금황색포도구균위주，점8.5%；진균이백색념주균위주，점8.5%，혁란음성균대두포고동/서파탄、아미잡성、아알배남최민감，혁란양성균대만고매소화체고랍저최민감。결론 AE-COPD환자병원균이혁란음성간균위주，내약솔편고，의거병원균분포급내약성감측결과지도항균약물적합리응용，시치료AE-COPD적중요수단。
Objective To investigate distribution and drug resistance of pathogens isolated from sputum of lower respiratory tract AE-COPD patients, so as to provide rerference and guidance for use of antibiotics. Methods The results of bacteria culture of sputum specimens and drug susceptibility testing from AE-COPD patients were analyzed retrospectively, VITEK-32 system was used to identify the microorganisms that were isolated from sputum of 142 patients lower respiratory tract infection,and K-B method was used for identify the antibiotics test. Results A total of 142 strains of pathogenic bacteria were isolated,including the gram-negative bacteria(70.4%), gram-positive bacteria(19.7%)and fungi (9.9%),Among the gram-negative bacteria,Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia、Acinetobacter baumanii were the most common;accounting for 31.7%, 11.9%, 9.9%and 9.9%respectively;Staphylococcus aureus was dominant in the gram-positive bacteria, accounting for 8.5%. Candida albicans was the main species of fungi, accounting for 8.5%.Cefoperazone/sulbactam,Amikacin and Imipenemwere most susceplibleto the gram-negative bacteia,Teicoplanin and Vancomycin were susceplible to gram-positive bacteia. Conclusion The gram-negative bacteia,are the major pathogens in AE-COPD patients, the drug resistance rates is high ,it is an important way to treat AE-COPD through the reasonable use of antibiotics in accordance with the result of survelliance of bacterial resistance.
