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目的:了解西宁地区慢性阻塞性肺病(COPD)患者痰培养的细菌种类及药物敏感性,为临床应用抗菌药物提供科学依据。方法:对我院2008年1月—2010年1月收治的110例COPD急性发作期住院患者痰培养和药物敏感性试验报告进行调查与分析。结果:经细菌学鉴定为革兰阴性杆菌80株(占72.73%),以克雷伯菌属的分离率最高,为29株(占36.25%);革兰阳性菌18株(占16.36%),以葡萄球菌属的分离率最高,为6株(占33.33%)。大多数革兰阴性杆菌对亚胺培南、舒巴坦/头孢哌酮敏感,其次是氨基糖苷类;革兰阳性菌属对万古霉素的敏感率为90.20%。真菌12例(占10.90%),其中白色念珠菌10例(占83.33%),霉菌2例(占16.67%),白色念珠菌对氟康唑敏感率为84.00%。结论:革兰氏阴性杆菌感染为西宁地区COPD患者感染的主要致病菌,真菌感染也占有一定比例。根据痰培养结果可对患者提供恰当的抗感染经验性治疗。
Objective: To understand the bacterial species and drug sensitivity of sputum culture in patients with chronic obstructive pulmonary disease (COPD) in Xining, and to provide a scientific basis for the clinical application of antibacterial drugs. Methods: A total of 110 hospitalized patients with acute exacerbation of COPD admitted to our hospital from January 2008 to January 2010 were investigated for sputum culture and drug sensitivity test. Results: 80 strains of Gram-negative bacilli (72.73%) were identified by bacteriology, 29 strains (36.25%) were Klebsiella species, 18 strains were Gram-positive bacteria (16.36%), , Staphylococcus aureus the highest isolation rate, 6 strains (33.33%). Most Gram-negative bacilli were sensitive to imipenem and sulbactam / cefoperazone, followed by aminoglycosides; Gram-positive bacteria were 90.20% sensitive to vancomycin. 12 fungi (accounting for 10.90%), of which Candida albicans 10 (83.33%), mold 2 (16.67%), candida albicans susceptibility to fluconazole 84.00%. Conclusion: Gram-negative bacilli infection is the main pathogen of COPD infection in Xining area, and the fungal infection also occupies a certain proportion. According to the results of sputum culture can provide patients with appropriate anti-infective empirical treatment.