目的 了解黃石市中心醫(yī)院不同年齡段慢性阻塞性肺疾病急性加重（AECOPD）住院患者感染病原菌分布情況及耐藥性特點。方法 分析黃石市中心醫(yī)院2013年1月-2017年10月痰培養(yǎng)檢出病原菌的554例AECOPD患者的病原菌分布和耐藥性。結果 40~65歲和≥ 65歲患者均以革蘭陰性菌為主，40~65歲患者排名前3位的病原菌分別為流感嗜血桿菌（18.54%）、銅綠假單胞菌（15.89%）和大腸埃希菌（13.58%）；≥ 65歲患者排名前3位的病原菌分別為銅綠假單胞菌（22.51%）、鮑曼不動桿菌（15.43%）和大腸埃希菌（14.15%）?！?65歲患者銅綠假單胞菌、鮑曼不動桿菌、嗜麥芽窄食單胞菌的分離率顯著大于40~65歲，流感嗜血桿菌、肺炎克雷伯桿菌和肺炎鏈球菌的分離率顯著小于40~65歲，差異均有統(tǒng)計學意義（P<0.05）?！?65歲患者銅綠假單胞菌和大腸埃希菌的耐藥率普遍大于40~65歲患者，其中銅綠假單胞菌對頭孢他啶、左氧氟沙星、環(huán)丙沙星的耐藥率和大腸埃希菌對哌拉西林他唑巴坦、頭孢他啶、左氧氟沙星、環(huán)丙沙星的耐藥率差異性均有統(tǒng)計學意義（P<0.05）。結論 黃石市中心醫(yī)院AECOPD患者病原菌均以革蘭陰性菌為主，但不同年齡段病原菌的構成和耐藥性并不完全相同。依據(jù)不同年齡段患者病原菌分布及耐藥性監(jiān)測結果指導抗菌藥物合理用藥，是治療AECOPD的關鍵。

Objective To understand the distribution and drug resistance of the pathogens for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in different age groups in Huangshi City TCM Hospital. Methods The distribution and drug resistance of pathogens detected by sputum culture of 554 cases of patients with AECOPD in Huangshi City TCM Hospital from January 2013 to October 2017. Results The main pathogens isolated from AECOPD patients with 40-65 years old and over 65 years old were Gram negative bacilli. The top of three pathogens of AECOPD patients with 40-65 years old were Haemophilus influenzae (18.54%), Pseudomonas aeruginosa (15.89%), and Escherichia coli (13.58%), and P. aeruginosa (22.51%), Bauman Acinetobacter (15.43%), and E. coli (14.15%) of AECOPD patients over 65 years old. The isolation rates of P. aeruginosa,B. Acinetobacter, and Stenotrophomonas maltophilia of AECOPD patients with over 65 years old were significantly greater than those of patients with 40-65 years old (P<0.05). The isolation rate of H. influenzae, Klebsiella pneumoniae, and S. pneumoniae of AECOPD patients over 65 years old were significantly less than 40-65 years old. The resistance rate of major Gram negative bacteria of AECOPD patients over 65 years old was greater than those of 40-65 years old, and there were significant difference in resistance rate of P. aeruginosa for ceftazidime, levofloxacin, ciprofloxacin, and E. coli for piperacillin, tazobactam, ceftazidime, levofloxacin, and ciprofloxacin between two age groups (P<0.05). Conclusion Gram-negative bacilli are the most common pathogens in the AECOPD patients in Huangshi City TCM Hospital, however, the composition and resistance of pathogenic bacteria in different age groups are not exactly the same. According to the distribution of pathogenic bacteria and drug resistance monitoring results of different age groups to guide rational use of antibiotics is the key to the treatment of AECOPD.