The Pathogen Characteristics In Patients With Acute Exacerbations Of Chronic Obstructive Pulmonary Disease And Its Relationship With Lung Function

ObjectiveTo study the composition of pathogenic bacteria、drug resistance rate and changin patients with acute exacerbation of chronic obstructive pulmonarydisease(AECOPD), and analyze distribution characteristics of pulmonary functionin each phase of AECOPD patients from January2010through December2013inrespiratory medicine,So as to better guide clinical treatment.MethodsDuring four years, the admitted medical records of acute exacerbation of chronicobstructive pulmonary disease(AECOPD) patients in our hospital respiratory areperformed statistical analysis and assignded to group A,patiens from January2010toDecember2011and to group B,patiens from January2012to December2013.Phlegm （All specimens by microscopy screening, the sputum specimens of each lowpower lens epithelial cells from the perspective of <10, neutrophils>25or both ratio<2.5as a qualified sputum specimens）or bronchial lavage training results ofinspection and the drug resistance rate are input to statistical analysis；meanwhile thestatistical result of the lung function which is divided into three stages,namely stageI,II,III,is collected and the differences of pathogenic bacteria of each phase ofthe lung function are analyzed.ResultsFrom January2010to December2013,455cases were collected, and theirspecimens culture208strains bacteria samples training, gram-negative bacteria ofwhich is145strains (69.71%)、 gram-positive bacteria37strains （17.79%）、fungus26strains (12.50%); Gram-negative bacteria includes pseudomonas aeruginosa (50strains), acinetobacter baumannii (29strains) and klebsiella bacillus (27strains), e.coli (25strains), eosinophilic malt narrow food (6strains), sewer intestine bacteriumcoli (4strains), onion burkholderia bacteria (4strains); Gram-positive bacteria isgiven priority to with staphylococcus aureus (25strains), and excrement enterococcus(5strains), staphylococcus epidermis (7strains); Fungi is candida albicans (12strains), tropical candida (6strains),(5strains) of aspergillus, g soft candida (3strains).The composition of gram-negative bacillus showes an decease trend, and grampositive bacteria shows a gradually increasing trend by comparing two groups;Results suggest that the main gram-negative bacillus are sensitive to carbonpenicillium alkene, cefoperazone-shu ba drugs and so on,but resistant rate is high inthe second generation cephalosporin, amikacin, levofloxacin. Gram-positivebacterium shows a high drug resistance to zithromycin, penicillin, whereasvancomycin,teicoplanin and linezolid keep higher sensitivity to bacteria. Comparingbacterial resistance between group A and group B, the resistant rate of mostcommonly used antibiotic for clinical common pathogenic bacterias rises. Fungi issensitive to amphotericin B and antifungal drugs. Based on lung function，AECOPDpatients is divided into stage I and stage II and stage III, and the number of each stagehas95cases,185cases,175cases,infection bacteria strains of which is21strains,85strains,102strains,respectively; The dual infection of the collection records occued in6people and triple infection in3people,all of which belong to patients with stageIII,which are altogether90people；thus bacteria detection rate in patients with stage I,II, III is21.11%,45.95%and51.49%respectively. The probability of infectiouspathogens in patients with stage III is higher, and these patients are more likely to beinfected with pseudomonas aeruginosa, acinetobacter baumannii, ficance,which are diverse in different lung function period.ConclusionsIn pathogenic bacteria isolated from samples of patients with AECOPD in ourrespiratory,of which gram-negative bacteria ranks the first and the number ofgram-positive bacteria and fungi in the bacterial composition has an increasing trendyear by year; the resistant rate of common pathogenic bacteria is high, and pathogenresistance in recent years is growing;the distribution of the pathogen of Lung functionat different stage is different, and patients in the phase III are more likely to beinfected with pseudomonas aeruginosa, acinetobacter baumannii,fungi.It is ofsignificant vaule for more reasonable empirical use of anti-infective drugs to improvethe clinical therapeutic effect and reduce the generation of drug-resistant byunderstanding the distribution and drug resistance of pathogen of copd,combinedwith pulmonary function in different periods pathogen infection characteristics.