论文部分内容阅读
目的通过对2011年1月~2015年8月我院需机械通气治疗的慢性阻塞性肺疾病急性加重期(AECOPD)患者病原学特点及耐药性进行总结,为此类患者获得及时、有效的治疗提供依据。方法对研究期内需转入重症监护室行机械通气治疗的AECOPD患者痰培养及药敏结果进行回顾性分析。结果共分离出病原菌137株,其中革兰阴性杆菌90株(65.7%),居于前5位的是铜绿假单胞菌、鲍氏不动杆菌、洋葱伯克霍尔德菌、阴沟肠杆菌、肺炎克雷伯菌;革兰阳性球菌18株(13.1%),常见的是金黄色葡萄球菌、肺炎链球菌;真菌29株(21.2%),以白色念珠菌及烟曲霉菌为主。药敏结果显示此类患者中革兰阴性杆菌耐药情况严重,其中以鲍氏不动杆菌尤为明显;革兰阳性球菌对大多数常见抗菌药物亦表现出较强耐药性,对利奈唑胺、万古霉素、替考拉宁保持较高敏感性。结论需机械通气治疗的AECOPD患者感染病原菌以革兰阴性杆菌及真菌为主,多重耐药情况严重,AECOPD患者的早期规范治疗应进一步引起重视。
Objective To summarize the etiological characteristics and drug resistance of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated with mechanical ventilation in our hospital from January 2011 to August 2015. To provide timely and effective Provide the basis for treatment. Methods The sputum culture and drug susceptibility results of AECOPD patients who needed to be transferred to intensive care unit for mechanical ventilation during the study period were retrospectively analyzed. Results A total of 137 pathogenic bacteria were isolated, of which 90 were Gram-negative bacilli (65.7%). Among the top 5, Pseudomonas aeruginosa, Acinetobacter baumannii, Burkholderia cepacia, Enterobacter cloacae, Klebsiella pneumoniae; Gram-positive cocci 18 (13.1%), common are Staphylococcus aureus, Streptococcus pneumoniae; 29 fungi (21.2%), Candida albicans and Aspergillus fumigatus-based. Drug susceptibility results show that patients with Gram-negative bacilli in this case of serious resistance, of which Acinetobacter baumannii is particularly evident; Gram-positive cocci most of the common antibacterials also showed strong resistance to linezolid , Vancomycin, teicoplanin to maintain a higher sensitivity. Conclusion The main pathogens of AECOPD patients requiring mechanical ventilation are Gram-negative bacilli and fungi. The multi-drug resistance is serious, and the early normative treatment of AECOPD patients should pay more attention.