COPD机械通气病人下呼吸道感染致病菌分布特点

①目的 探讨慢性阻塞性肺病(COPD)病人机械通气后下呼吸道感染致病菌的特点。②方法 取32例COPD并发呼吸衰竭行机械通气病人下呼吸道分泌物做痰细菌学培养，同时做药物敏感试验。③结果 32例病人共分离出菌株76株，阳性率71．7％，其中混合感染10例次。其中革兰阴性杆菌(GNB)58株，占76．3％；阳性球菌10株，占13．2％；真菌8株，占10．5％。常见致病菌以铜绿假单胞菌、鲍曼不动杆菌和肺炎杆菌为主，GNB中铜绿假单胞菌和不动杆菌的耐药率高。④结论 COPD应用机械通气病人下呼吸道感染以革兰阴性杆菌为主，耐药性高。

DISTRIBUTION OF PATHOGENS IN LOWER RESPIRATORY TRACT IN COPD PATIENTS WITH MECHANICAL VENTILATION

Objective To explore the characteristics of pathogens in the lower respiratory tract in COPD patients with mechanical ventilation. Methods The sputum was collected from the lower respiratory tract of 32 COPD patients with mechanical ventilation for bacteria culture and drug sensitivity. Results Seventy six colonies were identified with positive rate of 71.7% , of which, 58(76.3%) were gram negative bacteria(GNB), 10(13.2%) gram positive, and 8(10.5%) fungus. The most common pathogens were pseudomonas aeruginosa, acinetobacter and klebsiella. High rate of drug resistance was found in Pseudomonas and acinebacter. Conclusion GNB are the most common pathogens in the lower respiratory tract in COPD patients with mechanical ventilation and are highly drug resistant.