医学研究杂志
醫學研究雜誌
의학연구잡지
Journal of Medical Research
2015年
10期
131-134
,共4页
急性加重%慢性阻塞性肺疾病%支气管扩张%病原菌%耐药性
急性加重%慢性阻塞性肺疾病%支氣管擴張%病原菌%耐藥性
급성가중%만성조새성폐질병%지기관확장%병원균%내약성
Acute exacerbation%Chronic obstructive pulmonary disease%Brochiectasis%Pathogen%Drug resistance
目的 探讨合并支气管扩张的急性加重期慢性阻塞性肺疾病( AECOPD)感染病原菌分布及其耐药情况,指导临床合理用药. 方法 选择笔者医院2010年1月~2014年4月住院的98例合并支气管扩张的COPD急性加重期患者为研究对象,对所有患者痰标本中分离出的病原菌进行菌种鉴定和耐药性分析. 结果 共分离出66株病原菌,其中,革兰阴性杆菌52株,占78.8%;革兰阳性球菌5株,占7.6%;真菌9株,占13.6%. 最主要的革兰阴性杆菌依次为铜绿假单胞菌(27.3%)、大肠杆菌(13.6%)、肺炎克雷伯菌(12.1%)、鲍曼不动杆菌(10.6%)、阴沟肠杆菌(7.6%). 革兰阳性球菌以金黄色葡萄球菌(4.5%)为主. 革兰阴性杆菌耐药现象均较普遍,对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星敏感度较高. 金黄色葡萄球菌未发现对万古霉素耐药. 结论 合并支气管扩张的COPD急性加重期感染致病菌以革兰阴性杆菌为主,其次为真菌、革兰阳性球菌. 细菌耐药情况较为严重,应结合本地区病原菌分布特点及耐药状况,合理选用抗菌药物.
目的 探討閤併支氣管擴張的急性加重期慢性阻塞性肺疾病( AECOPD)感染病原菌分佈及其耐藥情況,指導臨床閤理用藥. 方法 選擇筆者醫院2010年1月~2014年4月住院的98例閤併支氣管擴張的COPD急性加重期患者為研究對象,對所有患者痰標本中分離齣的病原菌進行菌種鑒定和耐藥性分析. 結果 共分離齣66株病原菌,其中,革蘭陰性桿菌52株,佔78.8%;革蘭暘性毬菌5株,佔7.6%;真菌9株,佔13.6%. 最主要的革蘭陰性桿菌依次為銅綠假單胞菌(27.3%)、大腸桿菌(13.6%)、肺炎剋雷伯菌(12.1%)、鮑曼不動桿菌(10.6%)、陰溝腸桿菌(7.6%). 革蘭暘性毬菌以金黃色葡萄毬菌(4.5%)為主. 革蘭陰性桿菌耐藥現象均較普遍,對亞胺培南、頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星敏感度較高. 金黃色葡萄毬菌未髮現對萬古黴素耐藥. 結論 閤併支氣管擴張的COPD急性加重期感染緻病菌以革蘭陰性桿菌為主,其次為真菌、革蘭暘性毬菌. 細菌耐藥情況較為嚴重,應結閤本地區病原菌分佈特點及耐藥狀況,閤理選用抗菌藥物.
목적 탐토합병지기관확장적급성가중기만성조새성폐질병( AECOPD)감염병원균분포급기내약정황,지도림상합리용약. 방법 선택필자의원2010년1월~2014년4월주원적98례합병지기관확장적COPD급성가중기환자위연구대상,대소유환자담표본중분리출적병원균진행균충감정화내약성분석. 결과 공분리출66주병원균,기중,혁란음성간균52주,점78.8%;혁란양성구균5주,점7.6%;진균9주,점13.6%. 최주요적혁란음성간균의차위동록가단포균(27.3%)、대장간균(13.6%)、폐염극뢰백균(12.1%)、포만불동간균(10.6%)、음구장간균(7.6%). 혁란양성구균이금황색포도구균(4.5%)위주. 혁란음성간균내약현상균교보편,대아알배남、두포고동/서파탄、고랍서림/타서파탄、아미잡성민감도교고. 금황색포도구균미발현대만고매소내약. 결론 합병지기관확장적COPD급성가중기감염치병균이혁란음성간균위주,기차위진균、혁란양성구균. 세균내약정황교위엄중,응결합본지구병원균분포특점급내약상황,합리선용항균약물.
Objective To explore the distribution and antibiotic resistance of pathogenic bacteria isolated from sputum of patients with acute exacerbation of coexisting chronic obstructive pulmonary disease ( COPD) and bronchiectasis , so as to guide the rational antimi-crobial application in clinical practise .Methods Bacteria culture and drug susceptibility testing were performed for the sputum samples of 98 hospitalized patients with acute exacerbation of coexisting COPD and bronchiectasis from January 2010 to April 2014.Results A total of 66 strains of pathogenic bacteria were isolated in 96 patients, including 52 strains of Gram -negative bacilli(78.8%), 5 strains of Gram-positive cocci (7.6%) and 9 strains of fungi(13.6%).The five predominant Gram -negative bacterial species were P .aerugino-sa(27.3%), Escherichia coli(13.6%), Klebsiella pneumonia (12.1%), Acinetobacter baumannii (10.6%), and Enterobacter cloa-cae(7.6%).The effective antibiotics against Gram -negative bacterial infection in patients with acute exacerbation of coexisting COPD and brochiectasis included carbapenems , cefoperazone/sulbactam, piperacillin/tazobactam and amikacin .All the S.aureus strains in this stuy were sensitive to vancomycin .Conclusion The Gram -negative bacilli are the main pathogens in acute exacerbation of coexisting COPD and brochiectasis , followed by fungi and Gram -positive bacteria .As the problem of bacterial resistance is getting worse , antibiot-ics should be used more rationally according to the distribution of common pathogens and drug resistance trends in the region .
