目的：探讨支气管扩张症急性发作患者的感染病原菌分布及其耐药性情况。方法对本院收治的133例支气管扩张症感染加重期患者的痰培养、病原菌及药敏进行记录并分析。结果133例患者中痰培养样品出现阳性有62例，阳性率为46．6%，并从中分离得到82株菌株，且革兰阴性菌占85．4%(70/82)，革兰阳性菌占11．0%(9/82)，真菌占3．7%(3/82)。所有病原菌种主要以铜绿假单胞菌为主，占36．6%(30/82)。其次是肺炎克雷伯菌，占15．9%(13/82)，流感嗜血菌占12．2%(10/82)。药敏实验结果表明分离所得的多种革兰阴性菌均具有多重耐药性，尤其是肺炎克雷伯菌和大肠埃希菌，对环丙沙星、左氧氟沙星、氨苄西林、头孢呋辛、头孢噻肟的耐药率均>50%，显示较强的耐药能力。结论支气管扩张症急性发作患者感染的病原菌绝大多数为革兰阴性菌，且普遍耐药性较强。%Objective To explore the infectious pathogens distribution and drug resistance of patients with bronchiectasis at acute episodes. Methods The sputum of 133 patients with acute exacerbation of bronchiectasis was collected and cultured to analyze the distribution and antimicrobial susceptibility of pathogens. Results 46 cases of sputum culture were positive, accounting for 46. 6%. There were 82 stains isolated from those patients, which in-cluded 85. 4% of gram-negative bacteria (70/82), 36. 6% of gram-positive bacteria (9/82) and 3. 7% of fungi. The main pathogens was Pseudomonas aeruginosa (85. 4%), followed by klebsiella pneumoniae (15. 9%) and He-mophilus influenzae (12. 2%). Gram-negative bacterium showed multiple drug resistance, which especially Klebsiel-la pneumoniae and E. Coli showed a stronger drug-resistance to ciprofloxacin, levofloxacin, ampicillin, cefuroxime and cefotaxime. Conclusion The main infectious pathogens of patients with acute exacerbation of bronchiectasis are gram-negative bacteria, showing high drug resistance. The doctor should select proper antimicrobial agents according to bacterial culture and antimicrobial susceptibility testing results during clinical therapy.
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