| Objective: to analyse present situation of bronchiectasis with infection of pathogenic bacteria and drug resistance to commonly used antimicrobial agents.Methods: by review analysis(2011.1 ~ 2014.12) salt water selling hospital respiratory medicine treated 220 cases of acute infection in patients with bronchiectasis. Male 132, female 88, age 28-83, the average 55 and five years old. Smoking in 117 cases, 103 cases of non smoking. Merge sinusitis 125 cases, 95 cases of the merger of sinusitis. Duration of 30 cases of less than 10 years, 10 years to 30 years 82 cases, 108 cases of more than 30 years. File.usd10.00 sputum culture and serum detection of mycoplasma pneumoniae Ig M and the degree of antibody, and combined with clinical. According to the situation of pathogenic bacteria infection were divided into bacterial group atypical pathogens. The bacteria group is divided into G + bacteria and G- bacteria, fungi, Atypical pathogens mainly detect mycoplasma pneumoniae. At the same time on the pathogenic bacteria in patients with drug resistance analysis.Results:1, the patient general condition: 220 cases of patients, male 132, female 88 cases. Smoking patients 117 cases, 103 cases of patients without smoking. Combination of sinusitis patients 125 cases, 95 cases of the merger of sinusitis patients. Course of 30 patients with less than 10 years, 10 years to 30 years the patient 82 cases, 108 cases of patients with more than 30 years. 2, the pathogens of analysis: 2.1 bacteriology: 220 cases with acute infection in patients with bronchiectasis, 10 cases of G + bacteria was isolated, accounted for 4.55%(10/220). Enterococcus 4 cases, methicillin-resistant staphylococcus aureus 6 cases. Gram-negative bacteria 110 cases, accounting for 50%(110/220). The pseudomonas aeruginosa accounted for 41.82% of G- bacteria(46/110), with klebsiella pneumoniae accounted for 16.36% of G- bacteria(18/110), ultra broad spectrum beta lactamase bacteria(ESBLS(4 cases). Acinetobacter baumannii G- bacteria 10.91%(12/110), eosinophilic malt narrow food accounted for 6.36% of G- bacteria bacterium(7/110). Fungi are mainly candida albicans 30 cases, accounting for 13.64%(30/220). 2.2 atypical pathogens: 220 cases with acute infection in patients with bronchiectasis, there were 70 cases of merger mycoplasma pneumoniae infection, 31.8%(70/220). 2.3 sputum culture bacteria composition:(1) male G + 6 cases, 18 cases, fungus, G-68 cases, women’s G + 4 cases, 12 G- 42 cases, fungi,(2) G + 4 patients with smoking, G- 59 cases, fungi in 16 cases, G + 6 patients with non smoking, G- 51 cases, fungi, 14 cases;(3) with G + 4 patients with sinusitis, G- 62, fungi in 16 cases, the merger of sinusitis patients with G + 6 cases, G- 48 cases, fungi, 14 cases;(4) duration less than 10 years of 2 G + and G- 14 cases, 4 cases, 10 G + 30 years in 3 cases, G- 38 cases and fungi in 7 cases, more than 30 years of G + 5 cases, 58 cases of G- 19 cases, fungi. 3, isolated gram-positive bacteria, such as methicillin-resistant staphylococcus aureus and enterococcus, to clinical commonly used antibiotics such as penicillin G, ampicillin, cefalotin, ciprofloxacin, levofloxacin and erythromycin resistant rate of 100%, but for vancomycin resistant rate of 0%. Gram-negative bacteria, between different bacteria have different percentages. Pseudomonas aeruginosa to amikacin and gentamycin resistant rate of 0%, to the United States e.faecalis resistant rate 7.27%, the imine, south ni 9.09% of cefoperazone shu ba ni 23.64%, to piperacillin he azole resistance to 26.36%, of cefoperazone resistant rate of 42.73%, to piperacillin resistant rate of 52.73%. Klebsiella pneumoniae to e.faecalis resistant rate 0%, 0% prevalence of imine pei south resistance, amikacin resistant rate 5%, of cefoperazone shu ba ni 26.19%, to piperacillin he azole resistance to 28.57%, of cefoperazone resistant rate 35.71%, to piperacillin resistant rate of 54.76%. Acinetobacter baumannii e.faecalis resistant rate 33.33% to beauty and the imine culture south resistant rate 33.33%, amikacin resistant rate of 5%. The separation of the 4 cases of producing ESBLS with klebsiella pneumoniae, to the United States e.faecalis resistant rate of 0%, 0% prevalence of imine pei south resistance, gentamicin and chloramphenicol resistant rate of 25%, to piperacillin and piperacillin his temple, cefoperazone and cefoperazone and resistant rate 100%. 14cases of enzyme production strains, not to the United States e.faecalis resistant rate 0%, the imine culture south resistant rate 0%, 25% prevalence of gentamicin resistance, of chloramphenicol resistant rate of 21.88%, to piperacillin resistant rate of 46.88%, to piperacillin he azole resistance to 18.75%, 21.88% prevalence of cefoperazone resistance, to cefoperazone shu ba resistant rate 12.5%.Conclusion:1. The pathogen analysis: 1.1 this study found that of gram-negative bacteria of 110 cases, 50%(110/220). The pseudomonas aeruginosa accounted for 41.82% of G- bacteria(46/110). Patients with bronchiectasis, acute infection is given priority to with gram-negative bacteria, pseudomonas aeruginosa is most common. 1.2 this study acute infection in patients with pneumonia mycoplasma infection positive rate 31.8%. Showed that patients with acute aggravating period of mycoplasma pneumoniae infection rate also account for certain proportion. 1.3. The group of sputum culture of bacteria and patients’ sex, smoking, whether with sinusitis and onset time had no obvious correlation. 2, pathogen resistance analysis: 2.1 gram positive bacteria methicillin-resistant staphylococcus aureus and enterococcus to vancomycin resistant rate of 0%, have higher sensitivity to vancomycin. 2.2 gram negative bacteria such as pseudomonas aeruginosa to amikacin and gentamycin resistant rate of 0%, to the United States e.faecalis resistant rate of 7.27%, 9.09% prevalence of imine pei south resistance, klebsiella pneumoniae of e.faecalis resistant rate of 0%, 0% prevalence of imine pei south resistance, amikacin resistant rate 5%, hints of hydrocarbon enzyme alkenes, aminoglycoside antibiotics sensitivity is high. Pseudomonas aeruginosa to cefoperazone shu ba ni 23.64%, to piperacillin he azole resistance to 26.36%, the prevalence of cefoperazone resistance 42.73%, to piperacillin resistant rate of 52.73%. Klebsiella pneumoniae to cefoperazone shu ba ni 26.19%, to piperacillin he azole resistance to 28.57%, of cefoperazone resistant rate of 35.71%, to piperacillin resistant rate of 54.76%.Compared with piperacillin/he azole, piperacillin, its resistance significantly statistical differences. Compared to cefoperazone/shu ba, cefoperazone, its resistance significantly statistical differences. Prompt to compound containing beta lactamase inhibitor antibiotics sensitivity is higher. Producing ESBLS with klebsiella pneumoniae, to the United States e.faecalis resistant rate of 0%, 0% prevalence of imine pei south resistance, prompt hydrocarbon enzyme alkenes antibiotics on its good antibacterial activity. |
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