摘要
目的了解慢性阻塞性肺疾病急性加重期(AECOPD)下呼吸道病原菌分布及药敏情况。方法对412例AECOPD住院患者的痰培养及药敏结果进行分析。结果共分离出病原菌337株,其中革兰阴性杆菌207株占61.4%,主要为克雷伯菌属、铜绿假单胞菌、大肠埃希菌及不动杆菌属;革兰阳性球菌76株(22.6%),以葡萄球菌属为主;真菌54株占16.0%,以白色假丝酵母菌为主;革兰阴性杆菌耐药率较低的为多黏菌素(10.1%)、莫西沙星(12.1%)、头孢哌酮/舒巴坦(14.5%)、美罗培南(17.9%);万古霉素、替考拉宁、喹奴普汀/达福普汀、利奈唑胺对革兰阳性球菌有较好敏感性;克雷伯菌属、大肠埃希菌产ESBLs阳性率为74.5%,耐甲氧西林葡萄球菌属(MRS)阳性率为87.1%。结论 AECOPD患者下呼吸道感染病原菌以革兰阴性杆菌及葡萄球菌属为主,细菌耐药性监测对临床合理用药具有重要意义。
OBJECTIVE To analyze the distribution of pathogens in respiratory tract and their drug resistance in the patients with acute explosion chronic obstructive pulmonary disease（AECOPD）.METHODS A total of 412 sputum samples from COPD patients were collected from hospital.The results of sputum culture and the drug sensitivity were analyzed.RESULTS A total of 337 strains were isolated from all sputum samples,61.4% of them were Gram-negative,22.6% Gram-positive cocci and 16.0% epiphytes.Among the Gram-negative bacilli,the main pathogens included Klebsiella,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter;Staphylococcus was the most commom pathogens in Gram-positive cocci;Candida albicans was the most commom pathogens in epiphytes.The results of drug sensitivity test showed that most of the Gram-negative bacillis were more sensitive to polymyxin（10.1%）,moxifloxacin（12.1%）,cefoperazone/sulbactam（14.5%）and meropenem（17.9%）.Most of the Gram-positive bacilli were more sensitive to vancomycin,teicoplanin,quinupristin/dalfopristin and linezolid.The positive rates of ESBL-producing in Klebsiella and E.coli were 74.5%,the positive rate of MRS in Staphylococcus was 87.1%.CONCLUSION Gram-negative bacilli and Staphylococcus are predominant pathogens in AECOPD patients.The surveillance of bacterial resistance has great significance to the clinical use of drugs.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第7期1444-1446,共3页
Chinese Journal of Nosocomiology
关键词
慢性阻塞性肺疾病
病原菌
耐药性
Chronic obstructive pulmonary disease
Pathogen
Drug resistance
