【摘要】目的：研究探討支气管扩张合并感染患者病原菌分布、耐药性分析及肺功能相关性。方法：选取2016年1月-2018年12月本院收治的支气管扩张患者108例为研究对象，分别对患者进行痰培养实验、药敏性实验，并对患者的肺功能指标进行检测。探讨分析支气管扩张合并感染患者的病原菌分布及耐药性，以及与肺功能的相关性。结果：108例支气管扩张患者中病原菌检测阳性患者87例，患者感染阳性率为80.56%。87例患者经痰培养分离菌株94株，革兰阴性菌67株、革兰阳性菌22株，真菌5株。以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌占比最高。耐药性统计中主要致病菌对青霉素、氨苄西林、头孢呋辛、头孢唑林有较高的耐药率（>70%），对阿米卡星、妥布霉素、亚胺培南、哌拉西林的耐药率较低（<20%）。结论：支气管扩张合并感染患者细菌分布以革兰阴性菌为主。对于此类患者治疗应根据细菌培养、药敏实验合理选择抗生素进行针对性治疗。

【关键词】支气管扩张;病原菌感染;细菌分布;耐药性

【中图分类号】R446.5 【文献标识码】A 【DOI】10.12332/j.issn.2095-6525.2021.12.006

Distribution and drug resistance of pathogens in patients with bronchiectasis and infection

【Abstract】Objective：To study the distribution of pathogens， drug resistance analysis and correlation of lung function in patients with bronchiectasis complicated with infection. Methods： 108 patients with bronchial diffusions admitted to our hospital from January 2016 to December 2018 were selected as the research objects. sputum culture test and drug sensitivity test were carried out on the patients respectively， and the pulmonary function indexes of the patients were tested. To investigate and analyze the distribution and drug resistance of pathogens in patients with bronchiectasis complicated with infection， and the correlation with pulmonary function. Results： of 108 patients with bronchiectasis， 87 were positive for pathogenic bacteria， and the positive rate of infection was 80.56%. Ninety-four strains of bacteria， 67 strains of Gram-negative bacteria， 22 strains of Gram-positive bacteria and 5 strains of fungi were isolated from 87 patients by sputum culture. Pseudomonas aeruginosa， Klebsiella pneumoniae and Escherichia coli accounted for the highest proportion. In the drug resistance statistics， the main pathogenic bacteria had higher resistance rates to penicillin， ampicillin， cefuroxime and cefazolin （>70%）， while the resistance rates to amikacin， tobramycin， imipenem and piperacillin were lower （< 20%）. The pulmonary function indexes including forced expiratory volume （FEV1）， forced vital capacity （FVC） and maximum expiratory flow （PEF） in the positive group were lower than those in the negative group （P < 0.05）. With the aggravation of bronchiectasis， the infection of pathogenic bacteria increased significantly， while the indexes of pulmonary function decreased significantly. Conclusion： Gram-negative bacteria are the main bacteria in patients with bronchiectasis complicated with infection， and they are related to the pulmonary function of patients. For such patients， antibiotics should be selected according to bacterial culture and drug sensitivity test.

【Key words】Bronchiectasis; Pathogenic bacterial infection; Bacterial distribution; Drug resistance; Lung function

支气管扩张是呼吸系统常见疾病，是由于支气管及其周围肺组织慢性化脓性炎症和纤维化，使支气管壁的肌肉和弹性组织破坏，导致支气管变形及持久扩张[1]。该病发生后患者表现为癫痫的咳嗽、咳痰、间歇性发热、乏力、咯血等临床症状，对患者的呼吸功能及生活质量有着严重的不良影响。据流行病学观察显示，支气管扩张在临床上的发病率有逐年升高的趋势，对患者的危害性进一步加大[2-3]。……