Analysis of the pathogenic bacteria and drug resistance of sputum culture in patients with chronic obstructive pulmonary disease complicated with respiratory tract infection

Zhu Xinyu; Li Fang; He Wei; Jiang Lijuan; Zhu Tingting; Chen Lijuan; Wang Aiyue

doi:10.3760/j.issn.1673-4777.2026.01.009

Abstract：Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria in sputum culture of patients with chronic obstructive pulmonary disease(COPD)complicated with respir-atory tract infection.Methods COPD patients with respiratory tract infection who were diagnosed and treated in Northern Jiangsu People's Hospital,Jiangsu Province and the First Affiliated Hospital of Soochow University from January 2023 to December 2024 were selected as the research objects.The clinical data and sputum samples of the patients were collected,and the pathogen detection and drug resistance analysis were performed after sputum culture.Results A total of 628 patients were enrolled in this study.According to sputum samples,the patients were divided into sputum culture positive group(416 cases)and sputum culture negative group(212 cases).There were no significant differences in gender,age,year,infection month,and COPD course between the two groups(all P＞0.05).The results of pathogen detection showed that 177 strains(33.6％)were Gram-positive bacteria,324 strains(61.5％)were Gram-negative bacteria,and 26 strains(4.9％)were fungi.The main Gram-positive bacteria were Staphylococcus aureus(81 strains,45.8％),Streptococcus pneumoniae(54 strains,30.5％)and Staphylococcus epidermidis(28 strains,15.8％).Gram-negative bacteria were mainly Klebsiella pneumoniae(112 strains,34.6％),Acinetobacter baumannii(96 strains,29.6％),and Pseudomonas aeruginosa(83 strains,25.6％).The main Gram-positive bacteria showed high resistance rates to penicillin,azithromycin and levofloxacin,but were completely sensitive to vancomycin,teicoplanin and linezolid.Among the main Gram-negative bacteria,Klebsiella pneumoniae and Acinetobacter baumannii had high resistance rates to ampicillin,amoxicillin/clavulanic acid,ciprofloxacin,gentamicin,levofloxacin,tobramycin and cephalosporins,and low resistance rates to carbapenems such as imipenem and meropenem.Pseudomonas aeruginosa had high resistance rates to ampicillin,ceftriaxone,amoxicillin/clavulanic acid,and low resistance to gentamicin,tobramycin,imipenem,meropenem and most cephalosporins.Conclusion The pathogens in COPD patients with respiratory tract infection are complex and diverse,and the resistance rate to clinical first-line antibiotics is high.During the treatment,sputum culture and drug sensitivity test should be performed in time to guide clinical rational drug use.