Bacteriological Differences Between COPD Exacerbation and Community-Acquired Pneumonia
Bacteriological Differences Between COPD Exacerbation and Community-Acquired Pneumonia
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DOI：
10.4187/respcare.00915
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发表时间：
2011-11-01
期刊：
影响因子：
2.5
通讯作者：
Yuan, Qiao-Ying
中科院分区：
文献类型：
--
作者：
Li, Xue-Jun;Li, Qi;Yuan, Qiao-Ying
目的：研究慢性阻塞性肺疾病(COPD)急性加重期患者与社区获得性肺炎患者病原菌分布及药敏结果的差异，为临床合理用药提供依据。方法：对2007年1月至2008年12月收治的586例COPD急性加重期患者和345例社区获得性肺炎患者的痰培养结果、微生物药敏及临床特点进行回顾性分析。结果：276例COPD急性加重期患者痰培养阳性，183例社区获得性肺炎患者痰培养阳性。COPD急性加重期患者最常见的病原菌依次为铜绿假单胞菌、大肠杆菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌和流感嗜血杆菌。社区获得性肺炎患者最常见的病原菌是肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌、金黄色葡萄球菌和大肠杆菌。结论：铜绿假单胞菌是COPD急性加重期患者最常见的病原体，肺炎链球菌是社区获得性肺炎患者最常见的病原体。铜绿假单胞菌在严重或极严重的慢性阻塞性肺疾病患者中尤其常见。关键词：慢性阻塞性肺疾病；加重；社区获得性肺炎；细菌学。[Respir Care 2011；56(11)：1818-1824.(C)2011年Daedalus企业]
OBJECTIVE: To study the differences in pathogen distribution and antibiotic susceptibility between patients with COPD exacerbation and patients with community-acquired pneumonia, and develop guidance for antibiotic treatment of those conditions. METHODS: We retrospectively analyzed the medical records of 586 COPD-exacerbation patients and 345 community-acquired-pneumonia patients from January 2007 to December 2008, including sputum culture results, antibiotic susceptibilities of the microorganisms, and clinical characteristics. RESULTS: 276 (47%) of the COPD-exacerbation patients, and 183 (53%) of the community-acquired-pneumonia patients had a positive sputum culture. In order, the most common pathogens in the COPD-exacerbation patients were Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, and Haemophilus influenzae. The most common pathogens in the community-acquired-pneumonia patients were Streptococcus pneumoniae, H. influenzae, K. pneumoniae, S. aureus, and E. coli. CONCLUSIONS: P. aeruginosa was the most common pathogen in our patients with COPD exacerbation, and S. pneumoniae was the most common in our patients with community-acquired pneumonia. P. aeruginosa is especially common in the patients with serious or extremely serious COPD. Key words: COPD; exacerbation; community-acquired pneumonia; bacteriology. [Respir Care 2011;56(11):1818-1824. (C) 2011 Daedalus Enterprises]