ĐẶC ĐIỂM VI KHUẨN HỌC VÀ TÌNH HÌNH ĐỀ KHÁNG KHÁNG SINH Ở BỆNH NHÂN ĐỢT CẤP BỆNH PHỔI TẮC NGHẼN MẠN TÍNH KIỂU HÌNH NHIỀU ĐỢT CẤP

Abstract

Background: In chronic obstructive pulmonary disease patients and recurrent exacerbations, most exacerbations are severe and infected with drug-resistant gram-negative bacilli. Research on antibiotic resistance is positively impacting treatment outcomes. Objective: To investigate the bacteriological characteristics and antibiotic resistance in acute exacerbations hospitalized chronic obstructive pulmonary disease patients with frequent exacerbator phenotype. Materials and method: A cross-sectional study was conducted on 46 patients diagnosed with acute exacerbations of frequent exacerbator phenotype of chronic obstructive pulmonary disease with positive sputum culture, and admitted to Long An General Hospital from April 2023 to April 2024. Results: The average age of patients was 73.5 years old; the majority were men, and they often suffered from hypertension and diabetes. The proportion of isolated bacteria was mainly gramnegative bacteria, accounting for 90%, with the leading group being Klebsiella pneumoniae (38%), followed by Acinetobacter baumannii (23%), Pseudomonas aeruginosa (13%), Escherichia coli   (11%). Klebsiella pneumoniae was nearly 70% resistant to cephalosporins and quinolones, and 50% resistant to carbapenems. Acinetobacter baumannii was >60% resistant to all antibiotics, intermediate to colistin. Pseudomonas aeruginosa was 50% resistant to quinolones and 70% resistant to carbapenems, sensitive >60% to cephalosporins and aminoglycosides. Conclusion: Gram-negative pathogens are the most common bacterial group among patients with exacerbations of chronic obstructive pulmonary disease with multiple exacerbations. Cephalosporins, quinolones, and especially carbapenem resistance are ongoing problems.