Pathogenic Bacterium Distribution Of Sputum Culture And Analysis Of Antibiotics Resistance In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To analysis of AECOPD patients admitted by department of respiratory medicine of China-Japan Union Hospital of Jilin University in the past five years, investigate the statistic analysis on drug resistance and master the distribution of the pathogen of this disease and drug resistance in this region.Methods:Carry on statistic analysis on the results of sputum bacterial culture and drug resistance of all AECOPD patients admitted by department of respiratory medicine of China-Japan Union Hospital of Jilin University from January of2009to January of2013. Some of AECOPD patients are taken the specimens with the method of natural expectoration, others by the means of invasive mechanical ventilation assisting ventilation, such as tracheal intubation and artificial airway. Qualified specimens are conducted by statistic analysis with SSPS13.0and are represented by mean number plus standard deviation.Results:There are191patients of AECOPD meeting the required standards, and among them there are87males and104females. The average age is68.5±10.5and the number of actual days in hospital is14±7.5.The number of positive sputum culture cases is92.The positive rate of sputum culture is48.1%.The main pathogenic bacteria is gram-negative bacilli with71cases, accounting for76.8%of the positive sputum culture. The top three pathogens are:klebsiella pneumonia, acinetobacter baumannii and pseudomonas aeruginosa. Klebsiella pneumonia has extensive resistance to penicillin and a high sensitivity to piperacillin/tazobactam, cefoperazone/Sulbactam,(3-lactams and imipenem. Acinetobacter baumannii has a variety of drug resistance trends, which has a low resistance to piperacillin/tazobactam, cefoperazone and imipenem. Pseudomonas aeruginosa has a high sensitivity to imipenem and the fourth generation of cephalosporins and a high resistance to penicillins and the third generation of cephalosporins. In this article, there are17cases of gram-positive bacteria among191AECOPD patients accounting for18.4%of the positive sputum culture. The main pathogen is staphylococcus aureus followed by enterococcus. Gram-positive cocci has no resistance to vancomycin and linezolid. There are4fungus cases isolated from191cases of patients with AECOPD accounting for4.8%of positive bacteria, which is mainly candida albicans without making research. Besides, there are14cases using ventilators assisting respiration, including10cases of bacteria accounting for72.5%of the positive sputum culture, which is mainly acinetobacter baumannii. Multi-resistant bacteria are detected in the sputum culture.Conclusion:1:The main pathogen of AECOPD is gram-negative bacilli and is caused by bacterial infection, including klebsiella pneumonia, acinetobacter baumannii and pseudomonas aeruginosa. Gram-negative bacilli has a good sensitivity to imipenem and the fourth generation of cephalosporins and a high resistance to penicillins and β-lactams2:There emerges the situation of the multiple drug resistance using ventilators assisting respiration.3:In addition, distribution of pathogens in AECOPD patients has local differences.:4:The latest development of pathogens and drug resistance should be mastered in time in the clinic. It’s important to reasonably apply the detection of resistance on the antibiotics and bacterial drug, which provides basis for choosing antibiotics safely and effectively.