我院慢性阻塞性肺疾病急性加重期患者痰培养的病原菌分布及耐药性分析
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篇名: 我院慢性阻塞性肺疾病急性加重期患者痰培养的病原菌分布及耐药性分析
TITLE:
摘要: 目的:了解我院慢性阻塞性肺疾病急性加重期(AECOPD)患者痰培养的病原菌分布及耐药性,为临床合理用药提供参考。方法:收集我院2010年12月-2014年12月AECOPD患者痰液进行培养,对分离出的307株病原菌进行鉴定和药敏试验,数据采用SPSS 17.0软件进行统计、分析。结果:307株病原菌中,革兰阳性菌17株(占5.54%),革兰阴性菌247株(占80.46%),真菌43株(占14.00%);常见的病原菌是铜绿假单胞菌(33.22%)、鲍曼不动杆菌(19.54%)、嗜麦芽窄食假单胞菌(9.77%)、肺炎克雷伯菌(7.82%)和白色念珠菌(6.84%)等。铜绿假单胞菌和鲍曼不动杆菌多药耐药情况严重;检出产超广谱β-内酰胺酶肺炎克雷伯菌10株,检出率为41.67%;金黄色葡萄球菌中未检出万古霉素、替考拉宁、利奈唑胺耐药株,耐甲氧西林金黄色葡萄球菌检出率为50.00%。结论:AECOPD患者感染病原菌以革兰阴性菌为主,常见病原菌耐药性严重,临床应加强病原菌耐药监测,并结合药敏试验结果合理使用抗菌药物。
ABSTRACT: OBJECTIVE: To understand the distribution and drug resistance of the pathogens by sputum culture in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in our hospital so as to provide reference for rational use of antibiotics. METHODS: From Dec. 2010 to Dec. 2014, the sputum specimens were collected from the AECOPD patients, then the identification of 307 strains of pathogens and drug susceptibility test were carried out, and the data were analyzed statistically by using SPSS 17.0 software. RESULTS: A total of 307 strains of pathogens were collected, of which 17 cases of gram-positive bacillus accounted (5.54%), 247 cases of gram negative cocci (80.46%), 43 cases of fungi accounted (14.00%). The most common isolates from sputum specimens were Pseudomonas aeruginosa (33.22%), Acinetobacter baumannii (19.54%), Stenotrophomonas maltophilia (9.77%), Klebsiella pneumoniae (7.82%), Candida albicans (6.84%), etc. P. aeruginosa and A. baumannii were highly multidrug-resistant. There were 10 strains of ESBLs-producing K. pneumonia isolated, with the isolation rate of 41.67%. No Staphylococcus aureus strain was found resistant to vancomycin, teicoplanin or linezolid. Methicillin resistant strains in S. aureus (MRSA) accounted for 50.00%. CONCLUSIONS: Gram-negative bacilli are the most common pathogens in the AECOPD patients. The common species of pathogens are highly resistant. More attention should be paid to the drug resistance monitoring of pathogens and rational use of antibiotics according to the results of susceptibility test.
期刊: 2016年第27卷第8期
作者: 马莉,韩小年,彭莉蓉
AUTHORS: MA Li,HAN Xiaonian,PENG Lirong
关键字: 慢性阻塞性肺疾病急性加重期;病原菌;耐药性监测;痰培养
KEYWORDS: Acute exacerbation of chronic obstructive pulmonary disease; Pathogen; Drug resistance monitoring; Sputum culture
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