论文部分内容阅读
目的探讨慢性阻塞性肺疾病(COPD)患者下呼吸道感染病原菌分布特点及耐药性特征。方法收集COPD患者痰样本,进行普通细菌培养和真菌培养,采用Vitek2-Compact全自动细菌鉴定及药敏分析系统进行菌种鉴定和药敏试验。结果 COPD患者痰样本中病原菌阳性率为32.13%(98/305),革兰阴性杆菌(大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和奇异变形杆菌)占62.83%,革兰阳性球菌(金黄色葡萄球菌、肺炎链球菌和肠球菌)占13.07%,真菌(白色念珠菌和热带念珠军)占13.27%。革兰阴性杆菌对阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和美罗培南的耐药率均较低,均小于25%。金黄色葡萄球菌对青霉素、克林霉素、复方新诺明和红霉素的耐药率较高,未检出其对万古霉素耐药;肺炎链球菌对复方新诺明、克林霉素和红霉素耐药率较高,未检出对青霉素、万古霉素和美罗培南耐药菌株;肠球菌对复方新诺明、青霉素和克林霉素及利福平耐药较高,未检出对万古霉素和美罗培南耐药菌株。结论 COPD患者下呼吸道感染病原菌以革兰阴性杆菌为主,对多种抗生素耐药率较高。
Objective To investigate the distribution and drug resistance of pathogenic bacteria in lower respiratory tract infection in patients with chronic obstructive pulmonary disease (COPD). Methods Sputum samples of patients with COPD were collected for routine bacterial culture and fungal culture. Vitek2-Compact automatic bacterial identification and drug susceptibility analysis system were used to identify the bacteria and susceptibility testing. Results The positive rate of pathogens in sputum samples of patients with COPD was 32.13% (98/305), Gram-negative bacilli (Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Proteus mirabilis) Accounting for 62.83%, Gram-positive cocci (Staphylococcus aureus, Streptococcus pneumoniae and Enterococcus) accounted for 13.07%, fungi (Candida albicans and tropical rosary) accounted for 13.27%. Gram-negative bacilli were less resistant to amikacin, cefoperazone / sulbactam, piperacillin / tazobactam and meropenem, all less than 25%. Staphylococcus aureus penicillin, clindamycin, cotrimoxazole and erythromycin higher rate of resistance was not detected vancomycin resistance; Streptococcus pneumoniae cotrimoxazole, clindamycin And erythromycin resistant rate was higher, not detected against penicillin, vancomycin and meropenem resistant strains; enterococci on cotrimoxazole, penicillin and clindamycin and rifampin higher resistance, not seized Out to vancomycin and meropenem resistant strains. Conclusions Gram-negative bacilli are the main pathogens of lower respiratory tract infection in COPD patients, and the resistance rate to multiple antibiotics is high.