Clinical Research On Pathogens Distribution And Drug Resistance In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease In Elderly Patients

Objective: Analyze the sputum culture and drug sensitive test of inpatients in ourhospital to investigate pathogen species and drug resistance, and hope to provide valua-ble clinical reference for the selection of antibiotic agents.Methods: We collected the sputum of426older inpatients (>60years old) and74non-older inpatients (40~59years old) with AECOPD in our hospital during Jan.2012~and Dec.2012.The bacterum and fungal we found were cultured and do the experimentof pathogen susceptibility,then analyze the etiology and drug resistance characteristic-s,using statistical methods to analyze the potential correlation between pathogens andbasic diseases, age or cigarette.Results: Positive rate of sputum culture was30.52%in426older inpatients, of w-hich the single infection accounted for80%, mixed infection accounted for20%. Totally,164pathogens were found: Gram negative bacterium play a major role,96stains (58.5-4%）; fungus in the second,63stains（38.41%）; Gran positive bacterium rare,5stains（3.05%）.Top three Gram negative bacterium in sputum culture as follows:25Acinet-obacter baumannii（15.24%）,24Klebsiella pneumoniae（14.63%）,22Pseu-domonasaeruginos（a13.41%）. Positive rate of sputum culture was rare in74patients40-59yearsold,Only11（14.86%）, statistically significant comparing with the elderly group. Aci-netobacter baumannii infection is more in Age70or higher in elderly group and in thepatients with basic diease,statistically significant. The rate of pathogen detec-tion insmoker is higher than no-smoker,Pseudomonas aeruginosa infection rate is bigger insmoker than no-smoker, statistically significant. Half of Acinetobacter baumannii areresistant to antibiotic agents and20%are resistant to imipenem. Conclusion: Top three pathogens in sputum culture in older inpatient with AE-COPD in our hospital as follows: Acinetobacter baumannii, Klebsiella pneumoniae, P-seudomonas aeruginosa,and many of them resistant to antimicrobial agents,the rate ofpathogen detection in older inpatients is higher than patients40-59years old in our hos-pital. Acinetobacter baumannii is more in Age70or higher in elderly group than the gr-oup less than70years old,and more in patients with basic disease than the patients with-out basic disease;The rate of pathogen detection in smoker is higher than no-smoker,P-sedomonas aeruginosa infection is more in smoker than no-smoker.Acinetobacter bau-mannii resistant to more than half of antimicrobial agents.