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目的探讨临夏地区慢性阻塞性肺疾病(COPD)合并慢性肺源性心脏病(CCP)急性加重期患者病原菌的情况和类型。方法回顾性对COPD合并CCP急性加重期患者痰培养及药敏实验结果进行分析。结果培养出致病菌有417株,以G~-杆菌为主(279株,占67.9%),G~+球菌占第2位(125株,占30%),真菌占第3位(13株,占3.1%)。主要病原菌为肺炎克雷伯杆菌、肺炎链球菌、阴沟肠杆菌、金黄色葡萄球菌、大肠埃希菌。肺炎克雷伯杆菌、铜绿假单胞菌对青霉素、氨苄西林,头孢唑啉明显耐药,敏感性较好的药物有氨苄西林/舒巴坦钠、哌拉西林/他唑巴坦、头孢吡肟。万古霉素,利奈唑安对金葡菌及链球菌的敏感性较好,亚胺培南敏感性在80%以上。肺炎链球菌、金黄色葡萄球菌对青霉素的耐药性较高。结论临夏地区COPD合并CCP患者下呼吸道感染病原菌以G~-杆菌为主,对常用抗菌药物耐药性较高,应根据药敏试验进行选择。
Objective To explore the status and types of pathogens in chronic obstructive pulmonary disease (COPD) patients with acute exacerbation of chronic pulmonary heart disease (CCP) in Linxia region. Methods The sputum culture and drug susceptibility test results of patients with acute exacerbation of COPD complicated with COPD were retrospectively analyzed. Results There were 417 pathogenic bacteria (G - Bacillus subtilis, 279 (67.9%), 2 (125 strains, 30%) and 3 (13 Strain, accounting for 3.1%). The main pathogens are Klebsiella pneumoniae, Streptococcus pneumoniae, Enterobacter cloacae, Staphylococcus aureus, Escherichia coli. Klebsiella pneumoniae, Pseudomonas aeruginosa was significantly resistant to penicillin, ampicillin and cefazolin. The most sensitive drugs were ampicillin / sulbactam, piperacillin / tazobactam, ceftazidime Oxime. Vancomycin, linezolid safety of Staphylococcus aureus and Streptococcus, imipenem sensitivity of more than 80%. Streptococcus pneumoniae, Staphylococcus aureus higher resistance to penicillin. Conclusion The main pathogens of lower respiratory tract infection in COPD patients with COPD in Linxia region are G - Bacillus, which are resistant to commonly used antimicrobial agents and should be selected according to drug sensitivity test.