目的 分析COPD病人感染的病原菌组成情况及其耐药性与院内的耐药性比较。方法 采用VITEK全自动微生物鉴定系统鉴定病原菌，按NCCLS（美国临床实验室标准化委员会）的纸片扩散法进行耐药性、ESBLs（超广谱β-内酰胺酶）及MRS（耐甲氧西林葡萄球菌）检测，统计分析采用WHONET5.4软件进行。结果 培养出的革兰阴性菌中肺炎克雷伯、绿脓假单胞菌及大肠埃希菌占前3位，革兰阳性菌中以葡萄球菌和肠球菌为主，ESBLs、MRS检出率分别为78.5%与76.1%，Fisher确切概率计算法革兰阴性菌的耐药率明显高于全院患者所感染革兰阴性菌的平均水平。结论 COPD患者感染以革兰阴性菌较为多见，且耐药率明显高于全院水平，ESBLs、MRS检出率高，提示感染患者细菌的高耐药性。

Object To study the etiology of COPD sufferer and compare the drug sensitivity with whole hospital. Method Identify the bacterium by VITEK,detect the drug sensitivity、ESBLs and MRS with K-B method according to NCCLS, statistic analysis with WHONET 5.4. Result In positive samples, Klebsiella pneumoniae、Pseudomonas aeruginosa and Escherichia coli are responsible for the first、second and the third，Gram-positive bacterium are mostly consisted of Staphylococcus and Enterococcus，ESBLs and MRS are respectively 78.5%,76.1%. Fisher probabilities shows the drug resistance ratio of Gram-negative bacterium is higher than the whole hospital evidently. Conclusion In COPD sufferer，Gram-negative bacterium are in the ascendant and the drug resistance ratio is higher than whole hospital；high detection of ESBLs and MRS means the high drug resistance of the bacterium.