Analysis On Bacterial Infection And Drug Resistance In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective To understand patients with AECOPD the distribution and drug resistance of sputum bacteria,and to provide guidance for clinical anti-infection treatment of AECOPD through statistics analysis carried out to results of sputum culture,drug sensitive test and bacterial drug resistance of patients with AECOPD.Method543 patients with complete data definitely diagnosed of AECOPD were systematically retrospectivelly analysed from respiratory department of the second division of bethune First Hospital of Jilin University between 2015-01-01 to 2015-12-31.Sex,age,smoking history,sputum culture and drug sensitivity test results were investigated,and the species,distribution and drug resistance of pathogenic bacteria were studied by using retrospective analysis.As well,the patient’s gender,age,and smoking history were analyzed by using SPSS19.0 statistical software to understand whether the above three factors can affect the results of sputum culture.The chi-square test were used for categorical data analysis,and the difference was thought statistically significantly when P<0.05.Results422 of the 543 patients diagnosed with AECOPD met the criteria for admission and sputum culture,241 cases including 103 male and 138 female of 422 were sputum culture positive and he positive rate was 57.11%.The average age was 72.22 years-old.283 athogens were cultured of 241 cases of positive sputum culture,and gram-negative bacilli were 166 strains,accounting for 58.65% of the total number of bacterial strains.The top six Gram-negative bacilli In turn were: Klebsiella pneumoniae,Pseudomonas eruginosa,Bauman Acinetobacter,Enterobacter cloacae,Escherichia coli and Stenotrophomonas maltophilia.The number of Gram-positive bacteria was 8,accounting for about 2.83% of the total strains.The most common Gram-positive cocci is:Streptococcus neumoniae,Staphylococcus aureus and Streptococcus aeruginosa.The number of fungi was 109,accounting for 38.52% of the total strains.The first two fungi were Candida albicans and Candida glabrata.The drug resistance of gram-negative bacilli is as follows: mild resistance to carbapenem antibiotics,moderate resistance to aminoglycosides,fluoroquinolones antibiotics,high resistance to first generation cephalosporins and penicillin antibiotics.The detection rate of pathogenic bacteria in elderly patients with AECOPD was higher than that Prompting that elderly patients with AECOPD risking infection of Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,enterobacter,Bauman were greater than that of the non elderly group in non elderly patients(P<0.05),and the difference was statistically significant.Conclusion1、 The first rank of the pathogenic bacteria in the sputum culture of AECOPD patients is Gram-negative bacilli,the second is the fungus,the number of cocci is less.2、 AECOPD patients with pathogens are generally resistant to common antibiotics.3、 Elderly AECOPD patients with bacilli,fungal infection risk is higher than non-elderly group.