摘要
目的了解慢性阻塞性肺疾病急性加重(AECOPD)患者下呼吸道病原菌菌种分布及耐药性,为临床用药提供参考。方法回顾性分析首都医科大学附属北京世纪坛医院107例AECOPD住院患者痰培养及药物敏感性试验结果。结果分离出病原菌139株,其中革兰阴性杆菌81株(58.3%),以肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌为主;革兰阳性球菌35株(25.2%),以金黄色葡萄球菌、肺炎链球菌为主;真菌23株(16.5%),以白念珠菌为主。肺炎克雷伯菌、铜绿假单胞菌对头孢类抗菌药物耐药明显,对含β-内酰胺酶抑制剂及碳青霉烯类抗菌药物较为敏感;鲍曼不动杆菌仅对碳青霉烯类抗菌药物和头孢哌酮-舒巴坦有一定活性;金黄色葡萄球菌仅对万古霉素、利奈唑胺和替加环素较敏感。结论首都医科大学附属北京世纪坛医院AECOPD患者下呼吸道感染病原菌以革兰阴性杆菌为主,细菌耐药性监测对临床合理用药具有重要意义。
Objective To investigate the distribution and drug resistance of bacteria in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to provide a reference for clinical rational use of drugs.Methods The positive results of sputum culturing and the results of antimicrobial susceptibility test of 107 patients with AECOPD from Beijing Shijitan Hospital of the Capital Medical University were analyzed retrospectively.Results A total of 139 isolates were isolated,58.3%of them were Gram-negative bacilli,25.2%of them were Gram-positive cocci,and 16.5%of them were fungi.Among the Gram-negative bacilli,the main pathogens included Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa.Staphylococcus aureus and Streptococcus pneumoniae were the most common pathogens in Gram-positive cocci.Candida albicans was the most common pathogen in fungi.Klebsiella pneumoniae and Acinetobacter baumannii had the highest drug resistance to cephalosporin antibiotics,but were sensitive toβ-lactamase inhibitor compounds.Acinetobacter baumannii was only susceptible to carbapenem and cefoperazone-sulbactam.The antibiotic resistance of Grampositive cocci was serious,but vancomycin,linezolid and tigecycline were still effective.Conclusions Gramnegative bacilli are predominant pathogens in AECOPD patients from Beijing Shijitan Hospital of the Capital Medical University.The surveillance of bacterial resistance has significance to the clinical use of drugs.
作者
黄隽敏
庄须翠
秋爽
HUANG Junmin;ZHUANG Xucui;QIU Shuang(Department of Emergency Medicine,Beijing Shijitan Hospital,the Capital Medical University,Beijing 100038,China)
出处
《检验医学》
CAS
2020年第8期771-774,共4页
Laboratory Medicine
关键词
慢性阻塞性肺疾病
病原菌
耐药性
Chronic obstructive pulmonary disease
Pathogen
Drug resistance
