145例慢性阻塞性肺部疾病合并肺部感染患者痰培养及药敏结果研究.docVIP

145例慢性阻塞性肺部疾病合并肺部感染患者痰培养及药敏结果研究[摘要]目的:了解慢性阻塞性肺疾病合并肺部感染老年患者细菌感染趋势及其耐药情况。方法：对145例慢性阻塞性肺疾病合并肺部感染老年患者的痰标本进行细菌培养及药物敏感试验。结果：145例住院的慢性阻塞性肺疾病合并肺部感染老年患者的痰标本细菌分布为：革兰阳性菌感染占14.22%，革兰阴性菌感染占69.38%，真菌感染占16.40%。慢性阻塞性肺疾病下呼吸道感染以革兰阴性菌为主，革兰阳性菌和真菌感染有上升趋势。药物敏感试验显示，大多数革兰阴性菌对广谱抗生素耐药，对加酶抑制剂敏感率高。结论：临床上应重视细菌下呼吸道感染的耐药问题，合理使用抗生素。 [关键词]慢性阻塞性肺疾病；肺部感染；细菌培养；药物敏感试验 [中图分类号]R563 [文献标识码]B [文章编号]1673-7210（2007）11（b）-088-02 Analysis of phlegm raise and medicine sensitive test result in 145 patients with COPD incorporate pneumonia WU Ying,GU Li,YE Hui-ming (The First People’s Hospital of Neijiang,Neijiang 641000,China) [Abstract]Objective：To understand the bacterium infection tendency and drug resistant situation in aged patients with COPD incorporate pneumonia.Methods:145 aged patients’ phlegm specimen with COPD incorporate pneumonia were used to carry on the germ culture and medicine sensitive test.Results: Phlegm specimen’s bacterium distribution in 145 aged patients with COPD incorporate pneumonia was gram-positive bacterium infection accounting for 14.22%,gram-negative bacterium infection accounting for 69.38%, mycosis infection accounting for 16.40%; the main bacterium in low respiratory tract with COPD was gram-negative bacterium; gram-positive bacterium infection and mycotic infection were being on the rise in the meanwhile. Medicine sensitive test showed that most of gram-negative bacterium produced drug resistant on broad-spectrum antibiotic and had high sensitivity rate on inhibitor of enzyme.Conclusion: Clinicists should pay attention to the drug resistant problem of bacterial infection in low respiratory tract and make rational use of antibiotics. [Key words]COPD;Pneumonia;Germiculture;Medicine sensitive test 肺部感染是慢性阻塞性肺疾病急性加重的主要原因，亦是诱发呼吸衰竭导致死亡的重要原因。我院分析了慢性阻塞性肺疾病合并肺部感染老年患者的细菌感染趋势及其耐药情况，现报道如下： 1 资料与方法 1.1一般资料 对2006年1月～2007年3月在我院老年内科住院并具有完整细菌学资料的老年患者145例进行分析，全部病例均符合中华医学会呼吸病学分会制定的COPD诊断标准[1]和肺炎的诊断标准[2]。男性89例，女性56例，年龄60～92岁，平均69.5岁。 1.2方法 1.2.1 标本采集采用痰培养法收集标