Chronic obstructive pulmonary disease with acute aggravating period of etiology and drug resistance analysis

Abstract

Objective To analysis of chronic obstructive pulmonary disease in patients with acute exacerbation period (AECOPD) pathogenic bacteria distribution and use of antibiotics and provide reference for rational use of antimicrobial drugs for clinical norms. Methods It was collected 435 patients with acute aggravating period of COPD data from January 2014 to October 2017 for nearly three years in XiAn Tang Du hospital studied bacteria distribution and drug resistance. Besides, it was Analysis and comparison pathogenic bacteria distribution of secretions with invasive methods fiberoptic bronchoscopy of 149 cases of patients and non-invasive methods (natural deep sputum) 286 patients. Results The first, it was 275 patients (culture positive rate 63.22%) with isolated pathogenic bacteria, a single pathogen infection in 241 cases, 34 cases of mixed infection. Among them bacteria mixed infection in 16 cases, 18 cases of fungal infections bacteria merger. In 870 sputum samples, there were 452 sputum specimensthe qualified, accounting for 51.95%. All 309 strains pathogenic bacteria were isolated and cultured(detection positive rate 68.36%). with Gram-positive bacteria 60 strains(19.42%), staphylococcus aureus 24 strains, hemolytic streptococcus 17 strains, streptococcus pneumoniae 10 strains; Gram-negative bacteria 193 strains (62.45%), pseudomonas aeruginosa 56 strains, hemolytic acinetobacter bauman 36 strains, pneumonia klebsiella 27 strains; fungus 56 strains (18.13%), of which 27 strains aspergillus, 25 strains of candida albicans, 4 strains candida tropical. The secend, it was 124 patients with isolated pathogenic bacteria of 149 patients with invasion method to return secretion. There 136 strains of pathogenic bacteria were isolated and cultured, accounting for 83.22%. 286 patients with non-intrusive method isolated pathogenic bacteria was 151 cases. There 173 strains of pathogenic bacteria were isolated and cultured, accounting for 52.80%. Conclusion The first, it is given priority to AECOPD patients with gram-negative bacteria infection, mainly by pseudomonas aeruginosa and bowman/hemolytic acinetobacter.But it can′t ignore fungal infection. The secend, taking secretion under bronchoscope increased significantly pathogen detection rate (P<0.01). Patients with AECOPD were mainly infection of gram-negative bacteria, pathogen distribution no difference. Key words: Chronic obstructive pulmonary disease; Acute exacerbation; Pathogenic bacteria; Fiberoptic bronchoscopy