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目的分析ＣＯＰＤ机械通气并发下呼吸道医院感染病原学构成及耐药情况。方法６４例ＣＯＰＤ机械通气并发下呼吸道医院感染４２例，其病原学诊断全部采用经气管插管或纤维支气管镜深部采样送检痰培养及痰涂片检查而证实。结果共检出致病菌４８株。其中革兰阴性杆菌３２株，革兰阳性球菌１４株，真菌２株，前三位致病菌分别为：铜绿假单胞菌属１４株，不动杆菌属１０株，表皮葡萄球菌８株，药敏结果显示这类菌株多重耐药现象严重。结论ＣＯＰＤ机械通气并发下呼吸道医院感染病原体构成以革兰阴性杆菌为主，结合药敏结果联合应用抗菌药物值得临床重视。
Objective To analyze the etiological composition and drug resistance of nosocomial infection in COPD patients with lower respiratory tract infection. Methods Totally 64 cases of COPD with 42 cases of nosocomial infection of lower respiratory tract were enrolled. The etiological diagnosis was confirmed by deep tracheal intubation or bronchofibroscopy with sputum culture and sputum smear. Results A total of 48 pathogenic bacteria were detected. Among them, there were 32 Gram-negative bacilli, 14 Gram-positive cocci and 2 fungi. The first three pathogens were: Pseudomonas aeruginosa 14, Acinetobacter 10, Staphylococcus epidermidis 8, Susceptibility results show that these strains of multi-drug resistance is serious. Conclusions COPD-induced mechanical ventilation of lower respiratory tract pathogens in patients with Gram-negative bacilli dominated the combination of antimicrobial susceptibility results should be clinically valued.