Objective: To analyse the distribution of pathogens for patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) in different pulmonary function. Methods: 80 AECOPD patients from Augst 2013 to Augst 2015 in our hospital were selected. Censorship sputum,bronchoalveolar lavage fluid culture results, resistance rate and lung function grading results were tested and analysed.And the difference of pathogenic bacteria in different lung function level were analysed. Results: 72 pathogens were isolated from 80 patients.Gram-negative bacteria was the main type which accounting for 70.83%, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Escherichia coli-based.Gram-positive bacteria accounted for 16.67%, including Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus based. Fungi accounted for 12.50%, including Candida albicans, Candida tropicalis and Aspergillus based. Pseudomonas aeruginosa had a higher resistance rate to ticarcillin, ceftazidime and ticarcillin/clavulanate. Acinetobacter baumannii had a higher resistance rate to ampicillin/sulbactam, tobramycin, gentamicin and piperacillin.Klebsiella pneumoniae and Escherichia coli had a higher resistance rate to Ticarcillin/clavulanic acid, piperacillin/tazobactam, cefuroxime and cephalothin.The detection rate of Gram-negative bacteria in patients with lung function grade 2,3,4 was 50.0%, 52.0% and 66.7% respectively. Which was higher than patients with lung function grade 1(33.3.%).The detection rate of Gram-positive bacteria in patients with lung function grade 1, 2,3,4 was 50.0%, 37.5%, 24.0% and 9.1% respectively.The detection rate of grade 4 was significantly lower than grade 1 and 2(χ2=6.53,4.16; P<0.05).The detection rate of Fungus in patients with lung function grade 1, 2,3,4 was 16.7%, 12.5%, 24.0% and 24.2% respectively. Conclusion: Most AECOPD patients are infected with gram-negative bacteria.Resistance is very serious and the higher grade of lung function are more susceptible to be infect with gram-negative bacteria and fungi. |
[1] 张英,毛毅敏,孙瑜霞,等.老年慢性阻塞性肺疾病患者肺部感染的危险因素分析[J].中华医院感染学杂志,2014,24(12):3482-3483.
[2] CELLIB R,BARNES P J.Exacerbations of chronic obstructive pulmonary disease[J].Eur Respir J,2007,29(6):1224-1238.
[3] 钟南山,王辰.呼吸内科学[M].北京:人民卫生出版社,2008:110-111.
[4] FEI J,LU Y J,ZHAO D H.Analysis of predisposing factors,pathogenic bacteria and their drug sensitivity of pulmonary infection in lung cancer patients[J].J Clin Pulm Med,2013,18(1):8-9.
[5] 蒋雁,林奇龙,沈忠海,等.慢性阻塞性肺疾病急性加重期病原菌分布及耐药性分析[J].中华医院感染学杂志,2011,21 (7):1444-1446.
[6] 中华医学会呼吸病分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007 年修订版)[J].中华结核和呼吸杂志,2007,30(1):8-17.
[7] 王瑒,陈丽萍,李景姝.慢性阻塞性肺疾病肺间质性纤维化 CT 改变与肺功能分级的对比研究[J].现代预防医学,2012,39(20):5463-5464.
[8] 张连生,钟连江,顾春枫,等.糖尿病患者慢性阻塞性肺疾病急性加重期病原菌分析[J].中华医院感染学杂志,2015,25(7):3957-3959.
[9] LUIJKS H D,de GRAUW W J,BOR J H,et al.Exploring the impact of chronic obstructive pulmonary disease(COPD) on diabetes control in diabetes:a prospective observation study in general practice[J].NPJ Prim Care Respir Med,2015,23(25):32-33.
[10] 齐红松.慢性阻塞性肺疾病急性加重期病原菌特点及其与肺功能的关系[D].郑州:郑州大学,2012.
[11] 温庆辉,高元妹,黎凤英,等.下呼吸道分泌物细菌培养在慢性阻塞性肺疾病急性加重期的临床价值[J].重庆医学,2014,43(31):118-120.
[12] SHELTON B K.Opportunistic fungal infections in the critically ill[J].Crit Care Nurs Clin North Am,2010,12(8):323-334.
[13] 周佳杰,李丽兰.慢性阻塞性肺疾病急性加重期患者病原学及耐药分析[J].中国医药指南,2013,11(13):161-162.
[14] 张建,缪莉,艾尼娃,等.不同严重程度的慢性阻塞性肺疾病急性加重期患者痰培养菌种分布及耐药性分析[J].重庆医学,2011,40(30):3063-3064.
[15] 杨红辉,谢丽华,周妍,等.慢性阻塞性肺病患者感染的病原菌分布及耐药性分析[J].中国医院药学杂志,2010,30(16):1379-1383. |