摘要
目的通过回顾性分析我院诊断为慢性阻塞性肺疾病的住院患者的痰培养及药敏试验结果,探讨慢性阻塞性肺疾病患者的呼吸感染病原体分布及对抗生素的敏感情况,指导临床诊治。方法回顾性统计分析我院2016年1月~2018年12月慢性阻塞性肺疾病住院患者的痰培养及药敏试验结果,归纳分析患者的痰培养病原体种类,以及其对抗生素的敏感情况。结果慢性阻塞性肺疾病住院患者中呼吸道感染病原体以革兰氏阴性菌(83.57%)为主,前六名为铜绿假单胞菌(23.67%)、嗜麦芽窄食单胞菌(13.04%)、流感嗜血杆菌(9.66%)、肺炎克雷伯菌肺炎亚种(4.83%)、还包括肺炎克雷伯菌肺炎亚种ESBL阳性菌株(5.79%),鲍曼不动杆菌(5.31%),上述革兰氏阴性菌对第三代头孢、喹诺酮类、氨基糖苷类、碳青霉烯类药物敏感度仍高,耐药率<25.00%,但耐药菌株有增多趋势。革兰氏阳性菌(8.70%)中的肺炎链球菌(4.35%)、金黄色葡萄球菌(1.45%)对普通青霉素、喹诺酮类、万古霉素、利奈唑胺的敏感度仍高,耐药率<25.00%;其中金黄色葡萄球菌MRSA阳性菌株(2.90%)仅对万古霉素、利奈唑胺敏感度高。真菌感染占5.31%,对大多抗真菌药物的敏感度高,白色假丝酵母菌度特比萘芬的耐药率高。结论慢性阻塞性肺疾病住院患者呼吸道感染以革兰氏阴性菌感染为主,对临床上常见抗生素的敏感度尚可,但耐药菌株较前增多,应综合患者临床表现和痰培养及药敏结果规范使用抗菌药物。
Objective To explore the distribution of respiratory infection pathogens and sensitivity to antibiotics in patients with chronic obstructive pulmonary disease(COPD)by retrospectively analyzing the sputum culture and drug sensitivity test results of COPD inpatients diagnosed in our hospital,and to guide clinical diagnosis and treatment.Methods A retrospective statistical analysis of the sputum culture and drug sensitivity test results of COPD inpatients in our hospital from January 2016 to December 2018 was conducted,and the types of sputum culture pathogens and their sensitivity to antibiotics were summarized and analyzed.Results Gram-negative bacteria(83.57%)were the main pathogens of respiratory infection in hospitalized COPD patients.The top six were Pseudomonas aeruginosa(23.67%),Stenotrophomonas maltophilia(13.04%),Haemophilus influenzae(9.66%),Klebsiella pneumoniae pneumoniae subspecies(4.83%),ESBLpositive strains of Klebsiella pneumoniae pneumoniae subspecies(5.79%),Acinetobacter baumannii(5.31%).The abovementioned Gram-negative bacteria were still highly sensitive to third-generation cephalosporins,quinolones,aminoglycosides,and carbapenems,and the drug resistance rate was<25.00%,but the drug-resistant strains showed an increasing trend.Among Gram-positive bacteria(8.70%),Streptococcus pneumoniae(4.35%)and Staphylococcus aureus(1.45%)had higher sensitivity to ordinary penicillin,quinolones,vancomycin,linezolid,and drug resistance rate was<25.00%.Among them,Staphylococcus aureus MRSA positive strain(2.90%)was only sensitive to vancomycin and linezolid.Fungal infections accounted for 5.31%,and the sensitivity to most antifungal drugs was high.The Candida albicans terbinafine had higher resistance.Conclusion Gramnegative bacteria infections are the main respiratory infections in hospitalized COPD patients.The sensitivity to common antibiotics in the clinic is acceptable,but the number of resistant strains is higher than before.Patients'clinical manifestations,sputum culture,and drugs sensitivity should be considered to regulate the use of antimicrobials.
作者
温雅
杜焰家
黄娟
张伟强
WEN Ya;DU Yanjia;HUANG Juan;ZHANG Weiqiang(Department of Respiratory and Critical Care Medicine(the Second Department),Meizhou People's Hospital,Guangdong,Meizhou 514000,China)
出处
《中国医药科学》
2020年第13期25-31,共7页
China Medicine And Pharmacy
基金
广东省梅州市原卫生和计划生育局医药卫生科研课题(2017-B-40)。
关键词
慢性阻塞性肺疾病
痰培养
药敏试验
抗生素
Chronic obstructive pulmonary disease
Sputum culture
Drug sensitivity test
Antibiotic
