【摘要】 了解慢性阻塞性肺病(COPD)下呼吸道致病性革兰阴性杆菌的分布及耐药情况。收集江苏省宝应县人民医院2011年1月至2013年7月COPD患者下呼吸道标本,培养分离出的革兰阴性细菌,采用API试剂进行细菌鉴定及药敏试验,统计分析其临床分布及耐药性。共分离出355株革兰阴性细菌,β-内酰胺酶(ESBLs)在大肠埃希菌、肺炎克雷伯菌检出率分别为37.6%和32.9%,碳青霉烯类对肠杆菌科细菌和产ESBLs菌株和鲍曼不动杆菌属的抗菌活性最强,耐药率为0~6.2%,对阿米卡星、头孢哌酮/舒巴坦和哌拉西林/舒巴坦较敏感。铜绿假单胞菌对碳青霉烯类耐药率为23.7%;嗜麦芽窄食单胞菌对碳青霉烯类高度耐受,耐药率为100%。革兰阴性杆菌为COPD患者临床最常见致病菌,碳青霉烯类对除嗜麦窄食单胞菌外的其他革兰阴性细菌具有较好的抗菌活性。更多还原

【Abstract】 In order to understand the distribution and drug resistance of Gram-negative bacterium in lower respiratory tract of COPD( chronic obstructive pulmonary disease) patient,specimens from COPD patients were collected from January 2011 to July 2013 in the hospital,cultured and isolated the Gram-negative bacteria and identified and tested with API reagent for their drug sensitivity,then statistically analyzed their clinic distribution and drug resistance.There were 355 isolated Gram-negative strains,among them the examination rate of beta-lactamases( ESBLs) producing E. coli,K. pneumoniae were 37. 6%,32. 9% respectively,ESBLs producing strains were the most susceptible to imipenem and meropenem with resistant rates from 0 to 6. 2 %,they were highly sensitive to amikacin,cefoperazone /sulbact and piperacillin /tazobactam acid. P. aeuroginosa were 23. 7%,S. maltophilia was highly sensitive to imipenem and meropenem with the resistant rates of 100%. Therefore,Gram-negative rods in COPD patient were the main pathogens. Imipenem and meropenem remain highly active against gram-negative bacilli except S. maltophilia.更多还原