慢性阻塞性肺疾病急性加重期痰病原菌培养及药敏试验分析
|
摘要
目的观察慢性阻塞性肺疾病急性加重期(AECOPD)痰细菌病原菌构成及药敏试验。方法选择188例AECOPD患者作为研究对象,采集患者的痰液标本,并采用口痰培养法进行病原菌培养,先将其均匀涂片进行初筛,对合格痰样品进行细菌鉴定和药敏,同时依据Kirby-Bauer琼脂法进行补充药敏试验。分析患者病原菌分类及耐药性。结果在188例AECOPD患者中,分离出80株病原菌,阳性率为42.55%(80/188)。对病原菌进行分类,其中革兰阴性杆菌占78.75%,革兰阳性球菌占7.50%,真菌占6.25%,其他占7.50%。革兰阴性杆菌对三代头孢抗菌药物的耐药性比较高,亚胺培南对革兰阴性杆菌的抗菌活性最强,其次是阿米卡星、妥布霉素、左氧氟沙星等。对于革兰阳性球菌,万古霉素、喹奴普丁耐药性较低,具有治疗作用,但红霉素、克林霉素有较高的耐药性。结论 AECOPD痰培养结果复杂,耐药菌株检出率高,应查明AECOPD病原,并依据细菌药敏结果选择抗生素。
Objective To observe the formation and drug sensitivity test of phlegm bacteria pathogens in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 188 AECOPD patients were selected as research objects, sputum samples were collected and pathogenic bacteria culture was carried out by oral sputum culture, the uniform smear was screened first, bacterial identification and drug sensitivity of qualified sputum samples were carried up, meanwhile, the Kirby-Bauer agar method was used to carry out the drug sensitivity test. The classification and drug resistance of the pathogenic bacteria in patients were analyzed. Results In 188 patients with AECOPD, 80 strains of pathogenic bacteria were isolated, the positive rate was 42.55%(80/188). Pathogenic bacteria were classified, gram negative bacilli accounted for 78.75%, grampositive cocci accounted for 7.50%, fungi accounted for 6.25%, and others accounted for 7.50%. Gram-negative bacilli had high resistance to three generation cephalosporins. Imipenem had the strongest antibacterial activity to gram-negative bacilli, followed by Amikacin, Tobramycin and Levofloxacin. For gram-positive cocci, Vancomycin and Quinupristin had low drug resistance, and they had therapeutic effects, but Erythromycin and Clindamycin had high drug resistance. Conclusion The results of AECOPD sputum culture are complex and the detection rate of resistant strains is high. The pathogen of AECOPD should be identified, and antibiotics are selected according to the results of bacterial drug sensitivity.
Objective To observe the formation and drug sensitivity test of phlegm bacteria pathogens in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 188 AECOPD patients were selected as research objects, sputum samples were collected and pathogenic bacteria culture was carried out by oral sputum culture, the uniform smear was screened first, bacterial identification and drug sensitivity of qualified sputum samples were carried up, meanwhile, the Kirby-Bauer agar method was used to carry out the drug sensitivity test. The classification and drug resistance of the pathogenic bacteria in patients were analyzed. Results In 188 patients with AECOPD, 80 strains of pathogenic bacteria were isolated, the positive rate was 42.55%(80/188). Pathogenic bacteria were classified, gram negative bacilli accounted for 78.75%, grampositive cocci accounted for 7.50%, fungi accounted for 6.25%, and others accounted for 7.50%. Gram-negative bacilli had high resistance to three generation cephalosporins. Imipenem had the strongest antibacterial activity to gram-negative bacilli, followed by Amikacin, Tobramycin and Levofloxacin. For gram-positive cocci, Vancomycin and Quinupristin had low drug resistance, and they had therapeutic effects, but Erythromycin and Clindamycin had high drug resistance. Conclusion The results of AECOPD sputum culture are complex and the detection rate of resistant strains is high. The pathogen of AECOPD should be identified, and antibiotics are selected according to the results of bacterial drug sensitivity.
引文
[1]李伟,张肄鹏.慢性阻塞性肺疾病并发肺部感染病原菌分布及耐药性分析.国际检验医学杂志,2013,34(3):374-375.
[2]王玫红,怀丽梅,赵鑫亮.老年肺部感染患者病原菌耐药性分析及治疗策略.中华医院感染学杂志,2013,23(2):298-299.
[3]阙志文,胡守利.慢性阻塞性肺疾病并发肺部感染患者痰液病原菌检测情况分析.实用预防医学,2014,21(11):1376-1377.
[4]刘新年,王新卫,张彩霞,等.慢性阻塞性肺疾病并发肺部感染患者痰液病原菌检测情况分析.实用临床医药杂志,2015,191(13):142-144.
[5]季乐财,马雪,刘春龙.慢性阻塞性肺疾病急性加重期患者痰培养革兰阴性杆菌分布及耐药性分析.实用医学杂志,2017,34(4):297-298.
[6]张芳,何旭林,康文林,等.某区慢性阻塞性肺疾病合并慢性肺源性心脏病急性加重期患者的病原菌分析.中国医药指南,2017,15(13):41-43.
[7]何旭林,王海英,张芳,等.临夏市慢性阻塞性肺疾病合并慢性肺源性心脏病急性加重期患者病原菌分析.内科,2015,11(2):207-209.
[8]王浩,刘春龙,季乐财.慢性阻塞性肺疾病急性加重期患者痰病原微生物检出状况及3年演变.中国实用医药,2017,12(25):24-25.
[9]李娟,刘翩,王开金,等.慢性阻塞性肺疾病急性加重期呼吸道感染的病原菌分布和药敏分析.临床肺科杂志,2016,21(11):2003-2006.
[10]马莉,韩小年,彭莉蓉.我院慢性阻塞性肺疾病急性加重期患者痰培养的病原菌分布及耐药性分析.中国药房,2016,27(8):1058-1061.
[11]张爱兵.慢性阻塞性肺病急性加重期并肺部感染老年患者痰液的细菌培养及药敏分析.中国医药导报,2011,8(25):126-128.
[12]杨智,刘晓慧,符晓华,等.慢性阻塞性肺疾病急性加重期合并肺部感染239例痰培养和药敏结果分析.湖南师范大学学报(医学版),2011,8(1):37-39.
[13]马兴璇,刘春明,雷保中,等.111例慢性阻塞性肺病急性加重期痰细菌培养及药敏结果分析.广西医学,2008,30(4):552-554.
[14]刘娜.老年慢性阻塞性肺病急性加重期痰培养病原菌及药敏分析.中国医学创新,2014(26):107-109.
[15]王利平,肖振军.老年慢性阻塞性肺病急性加重期痰培养病原菌及药敏分析.湖南师范大学学报(医学版),2005,2(1):59-61.
[16]孙海玲.慢性阻塞性肺疾病急性加重期痰培养和药敏结果分析.中国医药指南,2010,8(35):48-49.
[17]罗兆文.慢性阻塞性肺疾病急性加重期患者痰培养结果分析.中国医药导报,2011,8(3):80-82.
[2]王玫红,怀丽梅,赵鑫亮.老年肺部感染患者病原菌耐药性分析及治疗策略.中华医院感染学杂志,2013,23(2):298-299.
[3]阙志文,胡守利.慢性阻塞性肺疾病并发肺部感染患者痰液病原菌检测情况分析.实用预防医学,2014,21(11):1376-1377.
[4]刘新年,王新卫,张彩霞,等.慢性阻塞性肺疾病并发肺部感染患者痰液病原菌检测情况分析.实用临床医药杂志,2015,191(13):142-144.
[5]季乐财,马雪,刘春龙.慢性阻塞性肺疾病急性加重期患者痰培养革兰阴性杆菌分布及耐药性分析.实用医学杂志,2017,34(4):297-298.
[6]张芳,何旭林,康文林,等.某区慢性阻塞性肺疾病合并慢性肺源性心脏病急性加重期患者的病原菌分析.中国医药指南,2017,15(13):41-43.
[7]何旭林,王海英,张芳,等.临夏市慢性阻塞性肺疾病合并慢性肺源性心脏病急性加重期患者病原菌分析.内科,2015,11(2):207-209.
[8]王浩,刘春龙,季乐财.慢性阻塞性肺疾病急性加重期患者痰病原微生物检出状况及3年演变.中国实用医药,2017,12(25):24-25.
[9]李娟,刘翩,王开金,等.慢性阻塞性肺疾病急性加重期呼吸道感染的病原菌分布和药敏分析.临床肺科杂志,2016,21(11):2003-2006.
[10]马莉,韩小年,彭莉蓉.我院慢性阻塞性肺疾病急性加重期患者痰培养的病原菌分布及耐药性分析.中国药房,2016,27(8):1058-1061.
[11]张爱兵.慢性阻塞性肺病急性加重期并肺部感染老年患者痰液的细菌培养及药敏分析.中国医药导报,2011,8(25):126-128.
[12]杨智,刘晓慧,符晓华,等.慢性阻塞性肺疾病急性加重期合并肺部感染239例痰培养和药敏结果分析.湖南师范大学学报(医学版),2011,8(1):37-39.
[13]马兴璇,刘春明,雷保中,等.111例慢性阻塞性肺病急性加重期痰细菌培养及药敏结果分析.广西医学,2008,30(4):552-554.
[14]刘娜.老年慢性阻塞性肺病急性加重期痰培养病原菌及药敏分析.中国医学创新,2014(26):107-109.
[15]王利平,肖振军.老年慢性阻塞性肺病急性加重期痰培养病原菌及药敏分析.湖南师范大学学报(医学版),2005,2(1):59-61.
[16]孙海玲.慢性阻塞性肺疾病急性加重期痰培养和药敏结果分析.中国医药指南,2010,8(35):48-49.
[17]罗兆文.慢性阻塞性肺疾病急性加重期患者痰培养结果分析.中国医药导报,2011,8(3):80-82.