[摘要] 目的 探索慢性阻塞性肺疾病(COPD)患者下呼吸道革兰阴性杆菌分离株的分布及耐药特点。方法 对2003年1月～2006年6月932例COPD患者院内下呼吸道感染标本中539株革兰阴性杆菌进行鉴定和药物敏感试验。结果 COPD患者院内下呼吸道感染776株病原菌中，革兰阴性杆菌占主要地位，占69.46%，其中非发酵菌占37.66%，大肠埃希菌占20.96%，肺炎克雷伯菌19.11%；药敏试验结果表明：所有革兰阴性杆菌对抗生素耐药率均较高，呈上升趋势。结论 我院COPD患者院内下呼吸道感染病原菌以革兰阴性杆菌为主。随细菌种类和耐药性发生变化，在治疗COPD医院感染时应根据药敏试验合理选择抗生素，避免盲目的经验用药，从而减少或减缓细菌耐药的产生。

    [关键词] 慢性阻塞性肺疾病；下呼吸道感染；革兰阴性杆菌；耐药性

    Organism distribution and drug-resistance analysis of gram-negative bacteria isolates from chronic obstructive pulmonary disease patients with lower respiratory tract infection

    HUANG Yu-rong，ZHANG Fang，GUO Su-jun，et al.Procluetion and Construction Corps Hospital,Xinjing 830002，China

    [Abstract] Objective To investigate the organism distribution and antibiotic-resistance of Gram-negative bacteria in COPD patients with lower respiratory tract infection to improve the therapeutic effect.Methods 539 of Gramnegative bacteria(GNB) from COPD patients with lower respiratory tract infection were classified and antibiotic susceptibility test was performed.Results Among 776 cases,the main pathogenesis were gram-negative bacteria,the rates were 69.46%.Organism isolated from patients in which the NFC was 37.66%,Escherichia coil was 20.96% and Klebsieella.pneumoniae was 19.11%.According to the drug sensitivity test,the antimicrobial resistance of Gram-negative bacilli was increasing.Conclusion GNB are the main pathogenesis isolated from nosocomial pulmonary infection in COPD.Great change took place in the bacteria distribution and drug-resistance.In order to avoid to abuse antibiotics,we should selected reasonable,according to the results in microbe detection. ......