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目的观察慢性阻塞性肺病急性加重期(AECOPD)住院患者痰培养病原菌种类和耐药性,为临床合理选择抗菌药物提供依据。方法收集医院2010年1月-2013年1月AECOPD患者212例,对其痰液培养阳性患者进行流行病学、住院次数、患病时间、病原菌分布及耐药性等进行比较分析。结果 AECOPD患者痰培养阳性61例,住院>3次35例、患病>5年48例,既往曾入住重症监护病房29例;痰液检出病原菌中革兰阴性杆菌52株占51.5%,革兰阳性菌23株占22.8%,真菌20株占19.7%,鲍氏不动杆菌对头孢唑林、磺胺甲噁唑/甲氧苄啶、氨曲南的耐药率较高,均为78.3%,铜绿假单胞菌对头孢唑林、头孢呋辛、头孢曲松耐药率较高,均为92.9%。结论因AECOPD呼吸道感染患者分离的病原菌以耐药革兰阴性菌为主,应于入院时针对性调整抗菌药物应用,以减少住院时间,降低住院费用。
Objective To observe the types and drug resistance of pathogenic bacteria in sputum of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to provide the basis for clinical rational choice of antibacterial drugs. Methods A total of 212 patients with AECOPD were collected from January 2010 to January 2013 in our hospital. The epidemiology, number of hospitalizations, prevalence, pathogen distribution and drug resistance of sputum positive patients were compared. Results AECOPD patients sputum culture was positive in 61 cases, hospitalization> 3 times in 35 cases, the prevalence of> 5 years in 48 cases, previously admitted to intensive care unit in 29 cases; sputum sputum pathogens found in 52 strains of gram-negative bacteria accounted for 51.5%, leather 23 strains of orchid positive bacteria accounted for 22.8%, 20 strains of fungi accounted for 19.7%, Acinetobacter baumannii cefazolin, sulfamethoxazole / trimethoprim, aztreonam resistance were higher, were 78.3% , Pseudomonas aeruginosa higher rates of cefazolin, cefuroxime, ceftriaxone, were 92.9%. Conclusion The pathogens isolated from patients with AECOPD respiratory infection are mainly resistant to Gram-negative bacteria. The application of antimicrobial agents should be adjusted on admission to reduce the hospitalization time and hospitalization costs.