摘要
目的分析糖尿病慢性阻塞性肺病(COPD)患者合并肺部感染的病原菌及药敏性。方法选取巫山县中医院2017年6月至2022年6月住院治疗的糖尿病COPD患者合并细菌性肺炎74例患者为观察组,选择同期住院的COPD合并细菌性肺炎112例患者为对照组,进行痰培养及药敏试验,比较两组患者的病原菌分布及药敏性。结果观察组被检测出病原菌106株,革兰氏阴性菌(G-)占比63.21%,主要革兰氏阴性菌依次为肺炎克雷伯菌(29.25%)、铜绿假单胞菌(16.98%)、鲍曼不动杆菌(8.49%),真菌占比24.53%,革兰氏阳性菌(G+)占比12.26%(13株),32例混合菌感染占比30.19%。对照组被检出病原菌124株,革兰氏阴性菌占比62.90%(78株),革兰氏阳性菌占比22.58%(28株),真菌占比14.52%(18株)。观察组的真菌、混合感染率高于对照组,革兰氏阳性菌检出率低于对照组,两组有显著差异性(P<0.05)。观察组的耐药率高于对照组(头孢唑林、青霉素除外),对革兰氏阴性菌敏感性高的药物是阿米卡星、亚胺培南,对革兰氏阳性菌敏感性高的药物是万古霉素、替考拉宁。结论铜绿单胞菌、肺炎克雷伯菌及鲍曼不动杆菌是糖尿病COPD患者合并肺部感染的主要感染病菌,这些病菌的耐药性相对较高,需要加强感染病原菌的监测,避免抗菌药物滥用而引起的真菌、混合菌感染。
Objective Analysis the distribution and drug sensitivity of diabetic COPD complicated with bacterial pneumonia,so as to provide reference for clinical rational use of drugs.Methods Totally 74 cases of diabetic COPD with bacterial pneumonia from 2017 to 2022 were selected as the observation group,and 112 cases of COPD with bacterial pneumonia in the same period were selected as the control group.The two groups were treated with phlegm culture and drug sensitivity test to compare for the distribution of pathogenic bacteria and drug sensitivity.Results In the observation group,106 strains of pathogenic bacteria were detected,of which Gram-negative bacteria(G-)accounted for 63.21%(67 strains).The main Gram-negative bacteria was Klebsiella pneumoniae(29.25%),Pseudomonas aeruginosa(16.98%),and Acinetobacter Bauman(8.49%),other there were 26 fungi(24.53%),Gram-positive bacteria(G+)accounted for 12.26%(13 strains),32 cases of mixed infection(30.19%).In the control group,124 strains of pathogenic bacteria were detected,with Gram-negative bacteria accounting for 62.90%(78 strains),Gram-positive bacteria accounting for 22.58%(28 strains)and fungi accounting for 14.52%(18 strains).The fungal and mixed infection rates of the observation group were higher than those of the control group,the detection rate of Gram-positive bacteria was lower than that of the control group,it is statistically significant differences.The drug resistance rate of the observation group was all higher than that of the control group(except cefazolin and penicillin).Gram-negative bacteria was highly sensitive to imipenem and amikacin,and Gram-positive bacteria was highly sensitive to tycorrine and vancomycin.Conclusion The diabetic COPD complicated with bacterial pneumonia are mainly Gram-negative bacillus infections such as klebsiella pneumoniae,pseudomonas aeruginosa and acinetobacter baumannii,which have high drug resistance.The clinical monitoring of pathogenic bacteria should be strengthened to avoid fungal and mixed bacterial infections caused by
作者
龙辉
李阿宁
罗云
LONG Hui;LI Aning;LUO Yun(Department of Intensive Care Unit,Wushan County Traditional Chinese Medicine Hospital,Chongqing 404799;Respiratory Department of Wushan County Traditional Chinese Medicine Hospital,Chongqing 404799;Department of Thoracic Surgery,Beibei Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine,Chongqing 400700,China)
出处
《中国老年保健医学》
2023年第6期69-72,共4页
Chinese Journal of Geriatric Care
基金
重庆市科卫联合课题项目(编号:2021ZY3712)。
关键词
慢性阻塞性肺病
糖尿病
细菌性肺炎
病原菌
耐药性
chronic obstructive pulmonary disease
diabetes
bacterial pneumonia
pathogen
drug resistance
