首页|慢性阻塞性肺疾病合并呼吸机相关性肺炎患者的痰培养病原学特征及耐药性分析

慢性阻塞性肺疾病合并呼吸机相关性肺炎患者的痰培养病原学特征及耐药性分析

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目的:分析慢性阻塞性肺疾病合并呼吸机相关性肺炎患者痰培养的病原学特征及耐药性.方法:选取 2022年 1 月至 2024 年 3 月65 例慢性阻塞性肺疾病合并呼吸机相关性肺炎患者,取痰液进行培养,记录痰培养的病原菌的构成及分布情况,采用标准纸片扩散法(Kirby Bauer,K-B 法)对主要菌株作耐药性试验,观察并记录各主要菌株的耐药情况.结果:65 例患者痰细菌培养阳性占比 90.77%(59/65),其中单一细菌占比 35.38%(23/65),细菌混合感染占比 55.38%(36/65),真菌与细菌混合感染占比 9.23%(6/65).痰培养病原菌共检出菌株 131 株,以细菌为主共 123 株,其中革兰氏阴性杆菌占比 77.24(95/123),革兰氏阳性球菌占比 22.7%(28/123).主要的革兰氏阴性杆菌中铜绿假单孢菌对多粘菌素B最敏感;鲍曼不动杆菌对替加环素最为敏感;大肠埃希菌以及肺炎克雷伯杆菌对替加环素和头孢吡肟较为敏感.主要的革兰氏阳性球菌中金黄色葡萄球菌以及凝固酶阴性表皮葡萄球菌对万古霉素敏感度最高.真菌中热带假丝酵母菌对氟康唑和伊曲康唑敏感度均较差;白色假丝酵母菌对伊曲康唑敏感度较好;近平滑假丝酵母菌对伊曲康唑敏感度较高.结论:本研究患者以混合感染多见,感染病原株以细菌为主,不同病原株耐药性有所差别,临床应根据实际情况选用.
Pathogenic characteristics of sputum culture and drug resistance in patients with chronic obstructive pulmonary disease and ventilator-associated pneumonia
Objective:To analyze the pathogenic characteristics and drug resistance of sputum cultures in patients with chronic obstructive pulmonary disease complicated by ventilator-associated pneumonia.Methods:A total of 65 patients with chronic obstructive pulmonary disease complicated by ventilator-associated pneumonia were selected from January 2022 to March 2024.Sputum samples were cultured,and the composition and distribution of pathogenic bacteria in sputum culture were recorded.The drug resistance test was performed on major strains using the standard disk diffusion method(Kirby Bauer,K-B method),and the drug resistance status of each major strain was observed and recorded.Results:In 65 patients,the positive rate of sputum bacterial culture was 90.77%(59/65),among which single bacteria accounted for 35.38%(23/65),mixed infection with bacteria accounted for 55.38%(36/65)and mixed infection with fungus and bacteria accounted for 9.23%(6/65).A total of 131 strains were detected in the sputum culture,mainly including bacteria(123),among which Gram-negative bacilli accounted for 77.24%(95/123)and Gram-positive cocci accounted for 22.7%(28/123).Among the main gram-negative bacteria,Pseudomonas aeruginosa is most sensitive to polymyxin B;Acinetobacter baumannii is most sensitive to tigecycline;Escherichia coli and Klebsiella pneumoniae are sensitive to tigecycline and cefepime.Among the main gram-positive cocci,Staphylococcus aureus and coagulase-negative staphylococcus epidermidis were most sensitive to vancomycin.Candida tropicalis in fungi has poor sensitivity to fluconazole and itraconazole;Candida albicans exhibits good sensitivity to itraconazole;Candida parapsilosis is highly sensitive to itraconazole.Conclusion:Mixed infections are common in patients with this study,and the infection strains are mainly bacteria.The drug resistance of different pathogenic strains varies,so clinicians should choose drugs based on actual conditions.

Chronic obstructive pulmonary diseaseVentilator-associated pneumoniaSputum culturePathogenic characteristicDrug resistance

谢婷婷

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兴国县人民医院检验科,江西 赣州 342400

慢性阻塞性肺疾病 呼吸机相关性肺炎 痰培养 病原学特征 耐药性

2024

四川生理科学杂志
四川省生理科学会

四川生理科学杂志

影响因子:0.575
ISSN:1671-3885
年,卷(期):2024.46(10)