摘要
目的了解医院慢性阻塞性肺疾病(COPD)患者下呼吸道感染病原菌分布及耐药性,为合理使用抗菌药物提供依据。方法选择2010年1月-2012年6月406例COPD发生下呼吸道感染患者的合格痰标本进行细菌学培养,采用VITEK-2Compact全自动微生物鉴定系统进行细菌鉴定和药敏分析。结果共检出病原菌292株,其中革兰阴性杆菌212株占72.7%,铜绿假单胞菌72株居首位,占24.7%,革兰阳性球菌36株占12.3%,主要以金黄色葡萄球菌为主,真菌44株占15.0%,主要为白色假丝酵母菌;革兰阴性杆菌对多数抗菌药物的耐药率>35.0%,对亚胺培南、美罗培南和哌拉西林/他唑巴坦的耐药率较低,金黄色葡萄球菌对青霉素G、氨苄西林100.0%耐药,未发现耐万古霉素和利奈唑胺菌株,假丝酵母菌属对两性霉素B、伊曲康唑、氟胞嘧啶、氟康唑、伏立康唑的耐药率分别为9.1%、18.2%、13.6%、27.3%、0。结论 COPD患者下呼吸道感染的病原菌以革兰阴性杆菌为主,已出现泛耐药菌株,万古霉素和利奈唑胺仍保持零耐药,抗真菌药物均具有较高的敏感率。
OBJECTIVE To understand the distribution of pathogens and drug resistance in patients with chronic obstructive pulmonary disease（COPD）in order to discuss how to use the antibiotics more effective and more reasonable.METHODS The qualified sputum samples of 406 cases of COPD patients who were hospitalized from Jan.2010 to Jun.2012 were chosen for bacteriological culture.Identification of bacteria and drug sensitivity analysis were proceeded by VITEK2-compact automatic microbial identification system.RESULTS A total of 292 pathogens were detected.Among them,212 strains of gram-negative bacilli were dominated,by the rate of 72.6%,with 72 strains of Pseudomonas aeruginosa ranking the top,accounting for 24.7%.Gram-positive cocci（36,12.3%）mainly included Staphylococcus aureus.Candida albicans was the main fungi（44,15.0%）.The drug resistance rate of the gram-negative bacilli to the majority of antibiotics was all above 35.0%,but they had lower rates to imipenem,meropenem and piperacillin/tazobactam.The drug resistance rate of S.aureus was 100.0%to penicillin G and ampicillin.Vancomycin-and linezolid-resistant strains were not found.The resistance rates of Candidato amphotericin B,itraconazole,5-fluorocytosine,fluconazole and voriconazole were 9.1%,18.2%,13.6%,27.3%,0.0%,respectively.CONCLUSION The pathogens of COPD patients with lower respiratory tract infection were mainly gram-negative bacilli.Pan-resistant strains have emerged.Vancomycin and linezolid remained zero resistance.Antifungal drugs have a higher sensitivity rate.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第14期3158-3160,共3页
Chinese Journal of Nosocomiology
基金
天津市卫生局科技基金资助项目(2011KY14)
关键词
慢性阻塞性肺疾病
下呼吸道感染
病原菌
耐药性
Chronic obstructive pulmonary disease
Lower respiratory tract infection
Pathogens
Drug resistance
