The Analysis Of Bacteria Distribution And Antibiotic Resistance In 365 Middle-aged And Geratic Patients Of Bronchiectasis

Bronchiectasis is irreversible dilatation of the bronchi, which is result from acute and chronic infection of the respiratioy tract, airway obstruction, and so on. These factors induce structure of the airway wall destruction. It is a frequent and continued to evolutional respiratioy disease. Chronic cough, expectoration and (or) repeating hemoptysis are the main symptoms. The infection and inflammation of the airway is the main factor, which lead to the bronchiectasis exacerbation and ceaseless progerssion. Therefore, if the infection is controlled, the disease will be gradually released. However, with the use of the antimicrobial, more and more resistant organisms appeared, which was result in bad curative effect of antimicrobial, and the infection was not controlled very well. The person has been paying attention to how to reasonably use antimicrobial, which could make resistant organisms reduce, and infection be effectively controlled. The microbic detection of the sputum is a good way, and helpful to reasonably use antimicrobial, which make us comprehend the bacteria distribution and the instance of the antimicrobial saitivity. We need to choose antimicrobial depend on the experience, because sputum culture need long time. Hence, in order to help the doctor reasonably select antimicrobial, 365 middle-aged and geratic patients of bronchiectasis analyzed retrospectively in respiratory department of our hospital from 2007 to 2009.The sputum culture amount is 261, and the examinational rate is 71.51%. The quantity of positive specimen is 80,and the positive rate is 30.65%. The total number of the pathogenic bacteria is 94, including 62 Gram negative bacterias, 3 Gram positive bacterias, and 29 funguses. And the rate of the three kinds of germs are 65.96%, 3.19%, 30.85% in all the pathogenic bacterias. The main bacteria is Pseudomonas aeruginosa in the Gram negative bacteria, and the number is 34, which has a rate of 36.17% in the total pathogenic bacterias. There are two bacterias which product extended spectrumβ-lactamases, and they are all Klebaiella product acid. Candida albicans is main in the funguses, and the quantity is 23, which has a rate of 24.47% in all the pathogenic bacterias. The Gram negative bacteria is resistant to ceftriaxone, piperacillin-tazobactam, chemitrim, and so on, but it is susceptible to the antibiotics which haveβ-lactamases inhibitor, the forth generational cephalosporin, quinolones, aminoglycosides, and so on. The resistant rate of Pseudomonas aeruginosa is higher than the Gram negative bacteria's. The resistance between the piperacillin-tazobactam and piperacillin is remarkably different in the Gram negative bacteria(P<0.01) and Pseudomonas aeruginosa(P<0.05). The resistance of the Klebaiella increases markedly, which products extended spectrumβ-lactamases, compared to the Klebaiella which do not have extended spectrumβ-lactamases.The infection of Gram negative bacteria is main for the middle-aged and geratic patients of bronchiectasis, especially the infection of Pseudomonas aeruginosa. The clinical doctors should choose susceptible antibiotics to the Gram negative bacteria and Pseudomonas aeruginosa for the new patients, at the same time, sputum culture is needed, because it can help us adjusting antibiotics, which makes the resistant organisn reduce.