Distribution of Pathogen and Analysis of Drug Sensitivity in Gerontal Patients with Chronic Obstructive Pul-monary Disease Accompanied by Pulmonary Infection
- VernacularTitle:老年慢性阻塞性肺疾病合并肺部感染的病原菌分布情况及药物敏感性分析
- Author:
Quan IN J
1
;
Haiying ZHOU
;
Zhixiong HU
Author Information
1. 复旦大学附属金山医院呼吸科
- Keywords:
Chronic obstructive pulmonary disease;
Pulmonary infection;
Pathogenic bacteria;
Drug sensitivity
- From:
Chinese Journal of Clinical Medicine
2014;(6):652-653,658
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the distribution of pathogen and the characteristics of drug resistance in gerontal patients with chronic obstructive pulmonary disease(COPD)accompanied by pulmonary infection,so as to provide the basis for rational usage of antibiotics.Methods:The sputum of 512 gerontal patients with COPD accompanied by pulmonary infection was collected for bacteria culture.The pathogenic distribution and drug sensitivity were analyzed.Results:There were 278 positive samples, with the positive rate of 54.3%.Of them,204 strains were gram-negative bacteria,including Pseudomonas (62 strains, 22.3%),Klebsiella (44 strains,15.8%),Haemophilus influenza (38 strains,13.7%),Enteric bacilli (34 strains,12.2%), and Acinetobacter (26 strains,9.4%).And 66 strains were gram-positive bacteria,including Staphylococcus aureus (32 strains,11.5%),Streptococcus pneumoniae (22 strains,7.9%),Enterococcus (12 strains,4.3%).Eight strains were fungi, including Candida albicans (6 strains,2.2%)and Yeast-like fungi (2 strains,0.7%).The rate of gram-negative bacteria was significantly higher than those of gram-positive bacteria and fungi(P <0.01).Gram-negative bacilli were most sensitive to mer-openem and imipenem,while they showed strongest drug resistance to ampicillin/sulbactam and amoxicillin.Gram-positive cocci were most sensitive to vancomycin and doxycycline,while they showed strong drug resistance to penicillin,erythromycin,clinda-mycin,levofloxacin,etc.The fungus had no resistance to flucytosine and fluconazole,ltraconazole and amphotericin B.Conclu-sions:The gerontal patients with COPD accompanied by pulmonary infection are mostly affected with gram-negative bacteria, which have high levels of resistance to antibiotics.According to experience,it is appropriate to choose the third and fourth generation cephalosporins or the compound antibiotics containing beta lactamase inhibitor for empiric treatment.
