Antibiotical resistance of pathogenic bacteria causing pulmonary infection in patients with chronic obstructive pulmonary diseases
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摘要: 目的:调查山区基层医院收治的慢性阻塞性肺疾病(COPD)并发肺部感染患者病原菌类别及其耐药性,为临床医师合理用药提供实验室参考依据。方法:病原菌培养鉴定严格按照《全国临床检验操作规程》,采用常规方法进行;药物敏感试验采用KB法,药敏结果按照美国国家临床实验室标准化研究所(CLSI)最新规则评价;采用WHONET 5.5版本统计分析数据。结果:COPD病原菌以革兰阴性杆菌为主(71.0%),所有病原菌对常用抗菌药物产生了较为严重的耐药性,其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率达41.9%,产ESBL细菌检出率达44.4%,耐碳青霉烯类抗生素的铜绿假单胞菌和鲍曼不动杆菌检出率达13.3%、20.0%。结论:我院COPD患者并发肺部感染病原菌的耐药性呈上升趋势,应加强细菌耐药性监测与控制。Abstract: Objective:To investigate bacterial species and antibiotical resistance of pathogenic bacteria causing pulmonary infection in patients with chronic obstructive pulmonary diseases (COPD) and provide the referrence for clinically reasonable use of antibiotics. Method:Referring to National guide to clinical laboratory procedures, pathogenic bacteria were cultured and identified by the routine methods. The antibiotical susceptibility testings were performed by K-B method. The susceptibility testings results were assessed according to the latest CLSI breakpoints and analyzed by WHONET 5.5 software. Result:Pathogens were mainly Gram-negative bacilli (71.0%). All pathogens had a more serious resistance to commonly used antimicrobial agents. Detection rate of methicillin-resistant staphylococcus aureus (MRSA) was 41.9%. That of ESBL-producing bacteria was 44.4%. Carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii arrived at 13.3% and 20.0%, respectively. Conclusion:The antibiotical resistance of pathogenic bacteria causing pulmonary infection in patients with COPD was increasing. We should strengthen monitoring and controlling of it.
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