2022-2023年某医院慢性阻塞性肺疾病合并肺炎患者的病原菌分布特征及耐药性分析OACSTPCD
Analysis of pathogenic distribution characteristics and drug resistance in patients with chronic obstructive pulmonary disease complicated with pneumonia
目的 分析慢性阻塞性肺疾病(COPD)合并肺炎患者的病原菌分布特征及耐药性.方法 选择 95829 部队医院呼吸科2022-01 至2023-12 收治的302 例COPD合并肺炎患者的临床资料,对其痰培养、药敏试验,病原菌分离结果进行分析,并对主要病原菌对常见抗菌药物的耐药情况进行调查.结果 2022 年共 154 例患者痰液标本培养分离出 231 株病原菌,菌种分布由高到低为革兰氏阴性菌、真菌、革兰氏阳性菌;2023 年共 148 例患者痰液标本培养分离出 209 株病原菌,菌种分布由高到低为革兰阴性菌、真菌、革兰阳性菌.2022 年、2023 年分别分离出铜绿假单胞菌 39 株、40 株,铜绿假单胞菌对阿莫西林/克拉维酸、氨苄西林完全耐药,对环丙沙星、阿米卡星耐药率低,对粘菌素未产生耐药性.2022 年、2023 年分别分离出肺炎克雷伯菌 36 株、37 株,肺炎克雷伯菌对氨苄西林完全耐药,对磷霉素、亚胺培南、替加环素耐药率低,对粘菌素未产生耐药性.2022 年、2023 年分别分离出鲍曼不动杆菌 27 株、25 株,鲍曼不动杆菌对妥布霉素、氨苄西林、阿莫西林/克拉维酸、左氧氟沙星完全耐药,对粘菌素未产生耐药性.2022 年、2023 年分别分离出大肠埃希菌 24 株、22 株,大肠埃希菌均对氨苄西林、哌拉西林耐药率高,对头孢哌酮/舒巴坦、亚胺培南、阿米卡星、磷霉素、呋喃妥因耐药率低,对替加环素未产生耐药性.结论 COPD合并肺炎患者的病原菌构成复杂,病原菌分布以革兰阴性菌为主,且不同病原菌的常见抗菌药物的耐药性存在差异,可根据痰培养、药敏试验结果针对性选用抗菌药物.
Objective To analyze the distribution characteristics and drug resistance of pathogens in patients with chro-nic obstructive pulmonary disease(COPD)complicated with pneumonia.Methods A total of 302 COPD patients with pneu-monia admitted to the Respiratory Department of the 95829th Military Hospital from January 2022 to December 2023 were se-lected as the subjects.Sputum culture,drug sensitivity test and pathogen isolation results were analyzed,and the resistance of major pathogens to common antibiotics was investigated.Results In 2022,231 strains of pathogenic bacteria were isolated from sputum samples of 154 COPD patients with pneumonia,and the distribution of bacteria from high to low were gram-nega-tive bacteria,fungi and gram-positive bacteria.In 2023,209 strains of pathogenic bacteria were isolated from sputum sam-ples of 148 COPD patients with pneumonia,and the distribution of bacteria from high to low were gram-negative bacteria,fungi,and gram-positive bacteria.In 2022 and 2023,39 strains and 40 strains of Pseudomonas aeruginosa were isolated re-spectively.Pseudomonas aeruginosa was completely resistant to amoxicillin/clavulanic acid and ampicillin,with low resist-ance rates to ciprofloxacin and amikacin,and did not developed resistance to colistin.In 2022 and 2023,36 strains and 37 strains of Klebsiella pneumoniae were isolated respectively.Klebsiella pneumoniae was completely resistant to ampicillin,had low resistance to fosfomycin,imipenem,and tigecycline,and had no resistance to colistin.Twenty-seven and 25 strains of Acinetobacter baumannii were isolated in 2022 and 2023 respectively.Acinetobacter baumannii was completely resistant to tobramycin,ampicillin,amoxicillin/clavulanic acid and levofloxacin,and did not develop resistance to colistin.In 2022 and 2023,24 and 22 strains of Escherichia coli were isolated respectively.All Escherichia coli had high resistance to ampicillin and piperacillin,low resistance to cefoperazone/sulbactam,imipenem,amikacin,phosphomycin and furantoin,and no re-sistance to tigecycline.Conclusions The pathogenic bacteria in COPD patients with pneumonia are complex,the distribution of pathogens is mainly gram-negative bacteria,and the resistance of common antibiotics in different pathogens is different.Antibiotics can be selected according to the results of sputum cul-ture and drug sensitivity test.
周洪青;秦冉展;严峻;刘娟;张婉迪
430000 武汉,95829部队医院呼吸科430000 武汉,95829部队医院呼吸科430000 武汉,95829部队医院呼吸科430000 武汉,95829部队医院呼吸科430000 武汉,95829部队医院呼吸科
临床医学
慢性阻塞性肺疾病肺炎病原菌分布特征耐药性
chronic obstructive pulmonary diseasepneumoniapathogenic bacteriadistribution characteristicsdrug resist-ance
《武警医学》 2024 (10)
833-837,5
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