摘要
目的分析老年慢性阻塞性肺疾病急性加重期(AECOPD)患者伴下呼吸道感染病原菌的分布及耐药性。方法选取2019年1月至2021年1月本院收治的120例老年AECOPD伴下呼吸道感染患者作为研究对象,采集所有患者呼吸道分泌物进行病原菌培养、鉴定、药敏试验,并统计结果,分析革兰氏阳性菌、革兰氏阴性菌对抗菌药物的耐药情况。结果20份送检标本中,共培养出细菌140株,其中革兰氏阳性菌40株,占比28.57%,以金黄色葡萄球菌、肺炎链球菌为主;革兰氏阴性菌82株,占比58.57%,以肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌为主;真菌18株,占比12.89%,以白假丝酵母菌、近平滑念珠菌为主。革兰氏阳性菌中,金黄色葡萄球菌、肺炎链球菌对青霉素、苯唑西林、克林霉素、左氧氟沙星等药物具有高耐药性(>50%),对替加环素、万古霉素、利奈唑胺极低耐药性(0.00%)。革兰氏阴性菌中,肺炎克雷伯菌对头孢唑啉、头孢曲松、头孢噻肟、左氧氟沙星具有高耐药性(>50%),对头孢哌酮-舒巴坦、亚胺培南、复方磺胺甲噁唑具有较低耐药性(<25%);鲍氏不动杆菌对头孢唑啉、头孢曲松、头孢噻肟、左氧氟沙星、氨曲南具有高耐药性(>50%),对头孢哌酮-舒巴坦具有较低耐药性(<25%);铜绿假单胞菌对头孢唑啉、头孢曲松、头孢噻肟、阿米卡星具有高耐药性(>50%),对头孢哌酮-舒巴坦、亚胺培南、复方磺胺甲噁唑具有较低耐药性(<25%)。结论金黄色葡萄球菌、肺炎链球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌是导致老年AECOPD患者发生下呼吸道感染的主要病原菌,临床应积极监测细菌耐药性,指导临床合理选择药物治疗,以促进患者康复。
Objective To analyze the distribution and drug resistance of pathogens in lower respiratory tract infections in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 120 elderly patients with AECOPD accompanied by lower respiratory tract infections admitted to our hospital from January 2019 to January 2021 were selected as the research subjects,respiratory secretions from all patients were collected for pathogenic bacteria,identification,and drug susceptibility testing,and the results were recorded;the drug resistance of Gram-positive bacteria and Gram-negative bacteria to antibiotics was analyzed.Results Among the 120 specimens,140 strains of bacteria were cultured,of which 40 strains were Gram-positive,mainly Staphylococcus aureus and Streptococcus pneumoniae,accounting for 28.57%;82 strains of Gram-negative bacteria,accounting for 58.57%,were mainly Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa;there were 18 strains of fungi,accounting for 12.89%,were mainly Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa.Among the Gram-positive bacteria,Staphylococcus aureus and Streptococcus pneumoniae showed high resistance(>50%)to penicillin,benzylpenicillin,erythromycin,and levofloxacin,while they exhibited very low resistance(0.00%)to tigecycline,vancomycin,and linezolid.Among the Gram-negative bacteria,Klebsiella pneumoniae showed high resistance(>50%)to cefalotin,ceftriaxone,ceftazidime,and levofloxacin,but low resistance(<25%)to ceftazidime-avibactam,imipenem,and co-trimoxazole.Acinetobacter baumannii showed high resistance(>50%)to cefalotin,ceftriaxone,ceftazidime,levofloxacin,and amikacin and low resistance(<25%)to ceftazidime-avibactam.Pseudomonas aeruginosa showed high resistance to cefalotin,ceftriaxone,ceftazidime,and amikacin(>50%),but low resistance(<25%)to ceftazidime-avibactam and imipenem.Conclusion Staphylococcus aureus,Streptococcus pneumoniae,Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aerugi
作者
刘云鹏
丛立涛
LIU Yunpeng;CONG Litao(Department of Clinical Laboratory,the First Hospital of Dandong City,Dandong,Liaoning,118000,China)
出处
《当代医学》
2023年第14期130-133,共4页
Contemporary Medicine
关键词
慢性阻塞性肺疾病
急性加重期
下呼吸道感染
病原菌
Chronic obstructive pulmonary disease
Acute exacerbation
Lower respiratory tract infection
Pathogenic bacteria
Drug resistanc
