Etiology Detection And Drug Sensitivity Analysis Of Bronchiectasis

Bronchiectasis is defined as irreversible dilatation of the bronchial tree. A bronchiectasis exacerbation was defined as an increase in symptoms (increased purulence and/or volume of sputum, increased shortness of breath) consistent with an infective exacerbation requiring admission to hospital for an intravenous course of antibiotics. Infection is an important factor in acute exacerbation of the disease,therefore controlling infection is the key point in the treatment of bronchiectasis.Bacterial resistance is different in different regions and hospitals, so it is important to know the pathogen and its drug resistance of bronchiectasis patients in our hospital for the guidance of the experience of drug use. We retrospect the sputum pathogen and drug resistance of 102 cases bronchiectasis patients in our department (from January 2005 to December 2008). All the patients were characterized as having bronchiectasis based on a history,symptom consistent with a HRCT scan of the chest. Since the patients admitted to hospital, the sputum sample was send to the microbial laboratory for culture. We choose the suspicious bacteria and perform the antibiotic sensitivity test.The research shows that there are 85 patients whose sputum was sent to the lab in 102 patients, the check rate is 83.33%. The sputum cultivation amount is 227, and the positive sample amount is 140, the positive rate is 61.67%. The check rate and positive rate of different course of diseases and the year admitted to hospital were not significant different. We separated 154 bacteria, the bacteria constitution has nothing to do with the admitted years and the course of disease. Among them there were 122 stains of gram negative(79.22%), 5 stains of gram positive(3.25%) and 27stains fungus.Pseudomonas aeruginosa rated the top one. The gram-negative bacteria displayed different drug-resistance. There was high sensitivity with imipenem, Meropenem,β-lactamase inhibitor compound of antibiotics and amino - glycoside antibiotics. There are 3 stains ESBLs producing Klebsiella pneumoniae, whose resistance is higher than the non-enzyme production strains. The imipenem and Meropenem remains good sensitivity to the ESBLs producing stains. Gram-positive bacteria are 100% sensitive to vancomycin. Candida albicans is common among the fungi. The infection often combined with bacterial, and the infection rate was significantly increasing with the course of diseases.Conclusion:1,Infection is an important factor in acute exacerbation of the disease,therefore controlling infection is the key point in the treatment of bronchiectasis.2,Sputum culture is an adequate tool for the evaluation of bronchial colonisation in these patients with bronchiectasis patients.3,The main infection of bronchiectasis was gram negative bacteria, especially the pseudomonas aeruginosa.4,The gram-negative bacteria displayed high sensitivity withβ-lactamase inhibitor compound antibiotics,imipenem,Meropenem and amino - glycoside antibiotics.5,Fungus is a common pathogen among the infection of bronchiectasis. The infection often combined with bacterial and the infection rate was significantly increasing with the course of diseases.6,We should select and adjust the use of antibiotics according to the results of drug sensitivity. It is important to study and analyse the drug resistance to direct the use of antibiotics periodicly.