Drug Resistance Monitoring Of Pathogenic Bacteria In AECOPD Patients And Analysis Of Influencing Factors Of Infection

【objective】1.To study the composition and drug resistance of pathogenic bacteria in sputum culture of patients with acute exacerbation of chronic obstructive pulmonary disease.2.Analyze the influencing factors of multi-drug resistant infection in the acute exacerbation of COPD,and provide theoretical basis for the clinical prevention and treatment of multi-drug resistant infection.【method】A retrospective analysis was conducted on the clinical characteristics,pathogen composition,drug resistance and influencing factors of multiple drug-resistant bacteria infection of 111 patients with AECOPD who met the inclusion criteria and were admitted to the inpatient wards of our hospital from May 2018 to May 2020.【results】1.During the two years,111 of the 664 AECOPD patients in our hospital were cultured with pathogenic bacteria,including 102 males and 9 females.The majority of the patients aged 80-89 years old(46 patients,accounting for 41.44%)were found.52 cases(46.89%)were found in respiratory department,followed by 34 cases(30.6%)in ICU and15 cases(13.51%)in geriatrics department.There were 65 patients(58.56%)with hypertension,followed by 39 patients(35.14%)with cerebrovascular accident,30 patients(27.03%)with diabetes,and 17 patients(15.32%)with coronary heart disease.2.A total of 127 strains of pathogenic bacteria were detected in 111 AECOPD patients,mainly Gram-negative bacteria,including Pseudomonas aeruginosa,Haemophilus influenzae,Acinetobacter baumannii,Klebsiella pneumoniae and Moraxella cataraxella.Multidrug-resistant bacteria accounted for 25.98% of the total detected pathogenic bacteria,among which Acinetobacter baumannii,Klebsiella pneumoniae,Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa were the most common.3.In this study,Pseudomonas aeruginosa was found to be the most sensitive to amicacin,and the drug resistance rate to ticacillin-clavulanate was high(58.33%).Haemophilus influenzae was sensitive to aminotronem,cefotaxime,meropenem,levofloxacin,piperacillin/tazobactam,and the drug resistance rate to cotrimoxazole was the highest(65.0%).Acinetobacter baumannii was the most sensitive to tigacycline and the highest resistance rate to piperacillin and tazobactam(93.3%).Klebsiella pneumoniae was also sensitive to tigacycline and had the highest resistance rate to doxycycline(83.3%).Among the gram-positive bacteria,Staphylococcus aureus was sensitive to vancomycin,tigacycline,tiraconin and linezolid,and the penicillin resistance rate was the highest(100%).The fungi were mainly Candida albicans,and no drug resistance was found.4.Univariate analysis results of MDRI showed significant statistical significance in gender,age,smoking history,associated hypertension,associated coronary heart disease,associated lung cancer,associated kidney disease,associated hypoalbuminemia,duration of antibiotic use and length of hospital stay between MDRI and non-MDRI patients.There was no significant statistical significance in whether diabetes mellitus,cerebrovascular accident,respiratory failure,frequent antibiotic replacement,mechanical ventilation,tracheotomy/endotracheal intubation,and indwelling urinary and gastric tubes.Hypertension,lung cancer,central venous catheter indwelling,antibiotic use time of > 14 d and hospital stay of > 14 d were independent risk factors for multi-drug resistant bacteria infection in AECOPD patients.【conclusion】1.Gram-negative bacteria were the main pathogenic bacteria in sputum culture of AECOPD patients in our hospital,mainly including Pseudomonas aeruginosa,Haemophilus influenzae,Acinetobacter baumannii,Klebsiella pneumoniae,Moraxella cataraxella,Gram-positive bacteria Streptococcus pneumoniae and Staphylococcus aureus.The detection rate of multi-drug resistant bacteria was high,up to 25.98%,and Acinetobacter baumannii was the main strain.2.Pseudomonas aeruginosa was sensitive to amicacin in sputum culture of AECOPD patients in our hospital.Haemophilus influenzae showed no obvious resistance to common drugs.Acinetobacter baumannii and Klebsiella pneumoniae were the most sensitive to tigecycline.Staphylococcus aureus was sensitive to vancomycin,tigacycline,tiraconin and linezolid.The fungi were mainly Candida albicans,and no drug resistance was found.3.Hypertension,lung cancer,central venous catheter indwelling,antibiotic use time of > 14 d and hospital stay of > 14 d were independent risk factors for multi-drug resistant bacteria infection in AECOPD patients.