Objective To investigate the distribution and antibiotic resistance of pathogens isolated fromlower respiratory tract in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) . Methods The patients with AECOPD, who were hospitalized in RICU from January 2008 to November 2009, were divided into a community infection group and a nosocomial infection group. Lower respiratory tract isolates were collected by bronchoscopic protected specimen brush for bacterial identification and susceptibility test. Results 134 cases were enrolled in the study, with 75 cases in the
community infection group and 59 cases in the nosocomial infection group. The positive detection rate in the nosocomial infection group was significantly higher than that in the community infection group [ 81. 4%( 48/59) vs. 54. 7% ( 41/75) ] . In the community infection group, 49 strains were isolated, in which gramnegative
bacteria, gram-positive bacteria, and fungi accounted for 55. 1% , 28. 6% , and 16. 3% , respectively.In the nosocomial infection group, 55 strains were isolated, in which gram-negative bacteria, gram-positive bacteria, and fungi accounted for 61. 8% , 21. 8% , and 16. 4%, respectively. There was no significant difference in the microbial distribution between the two groups ( P gt; 0. 05) . The detection rate of ESBLs producing strains in the nosocomial infection group was significantly higher than that in the community infection group ( 58. 8% vs. 37% ) . The resistance rates in the nosocomial groups were higher than those in the community infection group. Conclusions Antibiotic resistance is serious in mechanically ventilated patients with AECOPD, especially in the nosocomial infection patients. The increased fungi infection and drug resistance warrant clinicians to pay more attention to rational use of antibiotics, and take effective control measures.
Citation：
XU Ping,LIU Yuanyuan,SONG Weidong,ZENG Feiqiu,LUO Hua,YANG Hong. Distribution and Antibiotic Resistance of Isolates from Lower Respiratory Tract in Mechanically Ventilated Patients with COPD. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(4): 348-352. doi:
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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- 3. Clinical and Laboratory Standards Institute CLSI. 2006. Performance standards for antimicrobial susceptibility testing [ S] . sixteenth informational supplement.Wayne, Pa.
- 4. Nseir S, Di Pompeo C, Cavestri B, et al. Multiple diaig-resistant bacteria in patients with severe acute exacerbation of chronicobstructive pulmonary disease: Prevalence, risk factors, and outcome. Crit Care Med, 2006 , 34 : 2959-2966.
- 5. Wilson R. Bacteria, antibiotics and COPD. Eur Respir J, 2001, 17 :995-1007.
- 6. Ram FS, Rodrignez-Roisin R, Granados-Navarrete A, et al.Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2006, 19 : CD004403.
- 7. Marquette CH, Herengt F, MathieuD, et al. Diagnostic of pneumonia in mechanically ventilated patients. repeatability of the protected specimen brush. Am Rev Respir Dis, 1993, 147: 211 -214.
- 8. Bonomo RA, Szabo D. Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. Clin Infect Dis,2006, 43: S49-S56.
- 9. 武宁, 黄怡, 李强, 等. 呼吸科重症加强治疗病房院内肺部真菌感染47 例临床分析. 中国呼吸与危重监护杂志, 2008, 7: 182 -186.
- 10. Resende JC, de Resende MA, Saliba JL. Prevalence of Candida spp.in hospitalized patients and their risk factors. Mycoses, 2002, 45 :306-312.
