The Etiology And Drug Resistance Characteristics Of Patients With AECOPD Who Require Mechanical Ventilation Treatment

Objective:To provide guidance basis for timely and effective anti-infection treatment ,we summarized and analyzed the etiology characteristics and resistance to common antimicrobial drug of the people who require mechanical ventilation treatment with acute exacerbation of chronic obstructive pulmonary disease.Methods: Sputum specimens of patients hospitalized between January 2011 to August 2015 in our hospital were reviewed ,the patients were transferred to the intensive care unit to be line of mechanical ventilation,all specimens were examined for common bacteria, fungi and drug sensitive test,analyzed the pathogenic bacteria culture and drug sensitivity test results. The patients were divided into remission group and the non remission group, according to remission of the disease after transferring to the intensive care unit to be line of mechanical ventilation 7 days, the difference of pathogenic bacteria was compared between the two groups.Results: Sputum culture was positive in 115 of 212, the positive culture rate was 54.2%,single infection in 98 cases (85.2%)and mixed infection 17 cases (14.8%).A total of 137 strains were isolated from all sputum samples ,Gram-negative bacilli 90 stains(65.7%),the top five included Pseudomonas aeruginosa(22strains, 16.1%),Antibacterial baumannii( 19strains, 13.9%),Burkholdeia cepacia( 17strains, 12.4%),Enterobacter cloac-ae (10strains,7.3%),Klebsiella pneumoniae (6strains,4.3%);Gram-positive cocci 18 stains( 13.1 %),mainly including Staphylococcus aureus (10str-ains,7.3%)and Strep-tococcus pneumoniae(4strains,2.9%);Fungus 29 strains(21.2%),Candida Albicans(14strains,10.2%) and Aspergillus fumigatus (9strains,6.6%)were the most common pathogens.The top three pathogenic bacteria was different within five years,the ranking and constituent ratio of Pseudomonas aeruginosa showed a downward trend,those of Candida Albicans and Antibacterial baumannii showed an upward trend.There was no difference in the composition of Gram-negative bacilli,Gram-positive cocci and fungi between the remission group and the non remission group,but the top five pathogenic bacteria are different,the qualifying and constituent ratio of Antibacterial baumannii in the non remission group were higher than those in the remission group.Drug susceptibility results show that Pseudomonas aeruginosa bacteria to piperacillin / he tazobactam,piperacillin,Cefoperazone / sulbactam,tobramycin,amikacin resistance rate is below 50%,The strongest resistance to aztreonam Nannai was 72.7%;Antibacterial baumanniirug resistance is strong,the resistance rates of all kinds of antibacterial drugs were more than 70%;Gram-positive cocci drug resistance is also strong for common antibiotics, was sensitive to linezolid,vancomycin,teicoplanin.Conclusion :1.The main pathogenics of patients who require mechanical ventilation treatment with AECOPD were Gram-negative bacillus and fungus,the top five of Gram-negative bacillus included Pseudomonas aeruginosa,Acinetobacter bauman-nii ,Burkholdeia cepacia,Enterobacter cloacae,Klebsiella pneumoniae;Gram-positive cocci mainly including Staphylococcus aureus and Streptococcus pneumoniae;Candida Albicans and Aspergillus fumigatus were the most common pathogens in Fungus.2.The top three pathogenic bacteria was different within five years,the Pseudomonas aeruginosa showed a downward trend when Candida Albicans and Antibacterial baumannii showed an upward trend.3.There was no difference in the composition of Gram-negative bacilli,Gram-positive cocci and fungi between the remission group and the non remission group,but the top five pathogenic bacteria are different,the qualifying and constituent ratio of Antibacterial baumannii in the non remission group were higher than those in the remission group.4.Drug susceptibility results show that the gram-negative bacterium drug resistance in severe cases,particularly with Pseudomonas aeruginosa and Acinetobacter baumannii;Gram-positive cocci was sensitive to linezolid,vancomycin,teicoplanin.5.The composition of sputum pathogenic bacteria is complex in the people who require mechanical ventilation treatment with AECOPD and the heavy resistance in severe cases,we should pay more attention to the early standard treatment in patients with AECOPD.