Distribution Of Bacteriology And Analysis Of Antibiotics Resistance In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To analysis of antibiotic resistance and distribution of bacteriology from the sputum culture in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease who were hospitalized in the Bethune First,Second and Third hospital affiliated to the Jilin University in the recent five years, On one hand to get the information for the distribution of bacteriology and the present situation of antibioltic resistance locality,On the other hand to provide more information about choosing the antibiotics rational,effectively and experienced for the attending physician.Methods:Retrospectively analysis the results of sputum culture and antibiotic resistance from the patients who were diagnosed as Acute Exacerbation of Chronic Obstructive Pulmonary Disease hospitalized in the Bethune First,Second and Third hospital affiliated to the Jilin University from January 2006 until January 2011.The patients were removed if combining with Bronchiectasis,benign and malignant lung tumors or hospitalization less than 3 days.To obtain sputum samples via endotracheal intubation or artificial airway in patients with invasive mechanical ventilation,The remaining patients were taking direct method of expectoration to obtain sputum samples.The clinical data were statistically analyzed using SSPS 13.0 and indicated with a mean±standard deviation.Results:Including 263 male and 308 female were counted in our article, mean age 72.8±10.8 years,mean hospitalized days 14±7.8 days.275(48.2%) cases sputum samples were tested positive from 571 cases of patients with AECOPD. Including 210 cases Gram-negative bacilli accounted for 76.4% among the positives cases, Klebsiella pneumoniae is the most common bacterial followed by Acinetobacter baumannii,Pseudomonas aeruginosa. they were lower sensitive to benzylpenicillin,ampicillin and Paediatric Compound Sulfamethoxazole Tablets,highly sensitive to the 4th Cephalosporins, carbapenem andβ-lactamase inhibitor.36 cases Gram-positive cocci accounted for 13.1% among the positives cases,Staphylococcus aurous is the most common infection followed by Enterococcus. they are highly sensitively to vancomycin and more or less resistance to the other antibiotics.29 cases fungi accounted for 10.5% among the positives cases,Candida albicans is the most common fungi. The resistance of Antibiotic for fungi was not detected in our article.In addition,31 cases sputum samles were tested positive from 43 patients who were treated with invasive mechanical ventilation, accounted for 72.1% among the 43 patients. The multidrug resistant bacterial were cultured from the paitents who were treated with invasive mechanical ventilation.Acinetobacter baumannii is the most common bacterial among the results.Conclusion:Gram-negative bacili is the main pathogens in the patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.Klebsiella pneumoniae is the most common bacterial followed by Acinetobacter baumannii,Pseudomonas aeruginosa.The bacterial were highly resistance to penicillins andβ-lactamase inhibitor,highly sensitively to the 4th Cephalos-porins,carbapenem. Multidrug resistant bacterial were cultured from the paitents who were treated with invasive mechanical ventilation.According to the guideline and the bacterial specificity of locality to choose the sensitive and effective antibiotic before the sputum culture results were reported, because the distrubution of common bacterial was different in the different locality. Considering the infection except bacterial such as virus and non-common pathogens and preventing the fungi infection when the therapeutic are not effectively.