摘要
目的探讨支气管扩张症急性加重期患者下呼吸道病原菌分布特点和耐药情况,为临床合理用药提供依据。方法对2009年1月至2012年10月入住的124例支气管扩张症急性加重期患者的痰培养和药敏试验结果进行分析。结果 124例支气管扩张症急性加重期患者中53例痰标本培养出病原菌77株,检出率为42.7%,其中革兰阴性菌50株(64.9%),以铜绿假单胞菌居首位,占45.5%;革兰阳性菌8株(10.4%),其中金葡菌5株,均为耐甲氧西林金葡菌;真菌19株(24.7%),以白念珠菌为主。药敏试验结果显示所分离出的多种革兰阴性菌和金葡菌均具有多重耐药性,而且耐药率高。真菌已成为支气管扩张症的病原菌之一。病原菌培养阳性率与病程有关,随病程延长阳性率呈上升趋势。结论支气管扩张症急性加重期患者下呼吸道病原菌主要为革兰阴性菌,且耐药性较严重,治疗时应选择针对革兰阴性菌有抗菌活性的抗菌药物,同时应警惕耐药的金葡菌及真菌感染。
Objective To investigate the distribution and antibiotic resistance of pathogenic bacteria in patients with acute exac- erbation of bronchiectasis for improving empirical treatment. Methods Sputum culture and antimicrobial susceptibility testing were conducted for /24 patients with acute exacerbation of bronchiectasis who were admitted to our department from January 2009 to October 2012. Results The sputum cultures was positive in 53 of 124 cases （42.7%）. A total of 77 pathogens were isolated, 50 （64.9%） of which were gram-negative bacillus, particularly Pseudomonas aeruginosa. Eight strains （10. 4%） were gram-positive, mainly Staphylococcus aureus （all were methicillin-resistant, MRSA）. A total of 19 （24. 7%） fungal strains were isolated, mainly Candida albicans. Fungus is a common pathogen among the infection of bronchiectasis. The in fection rate significantly increased with the duration of disease. Conclusions The main pathogens in patients with acute exacer- bation of bronchiectasis were Gram negative bacilli which were highly resistant to antibiotics. Early empirical antibiotic therapy should consider the antimicrobial agents with relatively high activity against Gram-negative bacilli. Attention should also be paid to methicillin resistant Staphylococcus aureus and fungal infection.
出处
《中国感染与化疗杂志》
CAS
北大核心
2013年第5期380-383,共4页
Chinese Journal of Infection and Chemotherapy
关键词
支气管扩张症
急性加重期
病原菌分布
耐药性
bronchieetasis
acute exaeerbation
pathogen distribution
antibiotic resistance
