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目的 :为掌握慢阻肺 (COPD)急性加重期致病菌对一些抗菌药物的耐药情况 ,作为临床合理应用抗生素的依据 ,以期为临床治疗提供参考。方法 :采用经口痰菌培养 ,用VITEK -ATB和API系统鉴定菌种 ,药敏采用纸片扩散法。结果 :目前急性上呼吸道感染的主要致病菌群为革兰阴性杆菌 (72 9% ) ,其次为球菌感染 (2 7 1% )。药敏结果表明 ,细菌耐药严重 :对革兰阴性杆菌耐药率依次为亚胺培南、头孢他啶、阿米卡星、环丙沙星 ;约 70 %葡萄球菌为苯唑西林耐药株 ,并对多种抗菌药物耐药 ,但对去甲万古霉素均敏感 ;肠杆菌属对庆大霉素、哌拉西林、环丙沙星耐药率增高显著 ,对阿米卡星耐药率低 ;不动杆菌属中对优力新、喹诺酮类耐药率低。结论 :COPD急性加重期分离细菌对多种抗菌药物耐药率有上升趋势。明确致病菌、合理应用抗生素剂量及疗程、减少耐药菌株有实际意义。
OBJECTIVE: To understand the resistance of some pathogenic bacteria to some antibiotics in acute exacerbation of chronic obstructive pulmonary disease (COPD), and to provide basis for clinical rational use of antibiotics in order to provide reference for clinical treatment. Methods: Staphylococcus aureus culture was used. VITEK-ATB and API system were used to identify the strains. Drug susceptibility was determined by disk diffusion method. Results: At present, the main pathogens causing acute upper respiratory tract infection are Gram-negative bacilli (72.9%), followed by cocci infections (271%). The result of drug susceptibility showed that the bacteria was highly drug-resistant: the resistant rate to Gram-negative bacilli was imipenem, ceftazidime, amikacin and ciprofloxacin, and about 70% of the staphylococci were oxacillin- Resistant to many antimicrobial agents, but sensitive to norvancomycin. The resistance rates of Enterobacter to gentamicin, piperacillin and ciprofloxacin were significantly increased, and the rates of resistance to amikacin Low; Acinetobacter on the new force, quinolone resistance rate is low. Conclusion: The rates of resistance to multiple antimicrobial agents in isolates of acute exacerbation of COPD are on the rise. Clear pathogenic bacteria, rational use of antibiotic doses and courses of treatment to reduce drug-resistant strains of practical significance.