Abstract：Objective To observe the distribution and drug resistance in different course of COPD patients with lower respiratory tract infections. Methods A total of 623 COPD patients with lower respiratory tract infections who were detected the pathogens from Jan. 2015 to Mar. 2019 in Affiliated Hospital of Gansu Medical College were divided into the long-term disease group (>10 years) and the short-term disease group (≤10 years) by COPD course, and the distribution and drug resistance of the two groups of pathogens were compared. Results 281 patients were in the long-term disease group and 342 patients were in the short-term disease group, respectively. Gram-negative bacteria were the main pathogens in both groups, but the isolation rates of Gram-negative bacteria and fungi in the long-term disease group were higher than those in the short-course group (P<0.05). The isolation rates of Acinetobacter baumannii, Pseudomonas aeruginosa, ESBLs strains, and CRE strains in the long course group were higher than those in the short course group (P<0.05). The resistance rates of various pathogens to common antibiotics in long-term disease group were higher than those of short-term disease group. In the long-term group, the resistance rate of Klebsiella pneumoniae to meropenem was the lowest (32.79%), that of Acinetobacter baumannii to all antibiotics was more than 50%, those of Staphylococcus aureus to meropenem and tegacyclin was less than 30%. In the short course group, the resistance rates of Klebsiella pneumoniae to meropenem, imipenem, and moxifloxacin were less than 30%, those of Acinetobacter baumannii to cefoperazone/sulbactam, imipenem, and meropenem were about 30%; those of Staphylococcus aureus to imipenem, meropenem, and tegacyclin were less than 30%. No Staphylococcus aureus resistant to vancomycin and linezolid was isolated from the two groups. The resistance rate of Candida albicans to fluconazole was higher, and those to voriconazole and amphotericin B were lower in both group. Conclusion The pathogens of AECOPD patients with lower respiratory tract infections were mainly Gram-negative bacteria. The composition and drug resistance of pathogens were related to the course of COPD. The long-term disease group had a high detection rate of multi-drug resistant strains and fungi, and the drug resistance was severe.
习静 脱鸣富 魏育芳 戴红因 仇海龙 李宏科. 不同病程COPD并发下呼吸道感染病原菌分离及耐药情况分析#br#[J]. 中国抗生素杂志, 2020, 45(08): 798-803.
Xi Jing, Tuo Ming-fu, Wei Yu-fang, Dai Hong-yin, Chou Hai-long and Li Hong-ke. Analysis of pathogen isolation and drug resistance in different course of COPD patients with lower respiratory tract infection#br#. CJA, 2020, 45(08): 798-803.
