【摘要】 目的:分析老年慢性阻塞性肺疾病(COPD)的病原菌构成及耐药性,为临床合理选用抗菌药物提供参考。方法:对156例COPD患者的痰培养和药敏试验结果进行回顾性分析。结果:革兰阴性(G-)菌125株,以铜绿假单胞菌为首;革兰阳性(G+)菌48株,以金黄色葡萄球菌为首;真菌18株。铜绿假单胞菌对氨苄西林/舒巴坦、头孢哌酮/他唑巴坦、亚胺培南和头孢他啶的耐药率均<35%;肺炎克雷伯菌和大肠埃希菌对氨苄西林/舒巴坦、头孢哌酮/他唑巴坦和亚胺培南耐药率均<35%;鲍曼不动杆菌除了对亚胺培南和头孢哌酮/他唑巴坦敏感外,对其他药物的耐药率均>60%。G+菌耐药性严重,但对万古霉素和替考拉宁敏感率均为100.0%。结论:老年COPD患者的主要病原菌为G-菌,呈现出多重耐药性,耐药率也不断增加。更多还原

【Abstract】 OBJECTIVE:To analyze the etiology composition and drug resistance of senile COPD,and to provide reference for rational use of drugs in the clinic.METHODS:The results of sputum cultures and drug sensitive test in 156 senile COPD patients were analyzed retrospectively.RESULTS:There were 125 strains of Gram-negative bacteria,the most of them were Pseudomonas aeruginosas.There were 48 strains of Gram-positive bacteria,the most of them were Staphylococcus aureus,and there were 18 strains of fungus.The drug resistant rates of Pseudomonas aeruginosa to ampicillin/sulbactam,cefoperazone/tazobactam,imipenem and ceftazidine were all lower than 35%.The drug resistant rates of Klebsiella pneumoniae and Escherichia coli to ampicillin/sulbactam,cefoperazone/tazobactam and imipenem were all lower than 35%.Except being sensitive to imipenem and cefoperazone/tazobactam,the drug resistant rate of Acinetobacter baumannii to other drugs was more than 60%.The drug resistance of Gram-positive bacteria was severe,but its sensitive rates to vancomycin and teicoplanin both were 100.0%.CONCLUSIONS:The main pathogenic bacteria of senile COPD patient is Gram-negative bacteria and shows multiply resistance with increasing drug resistant rate.更多还原