摘要
目的：了解肺结核合并肺部混合细菌感染者病原菌及其耐药性，探讨此类患者经验性用药时抗生素的选择。方法：对住院肺结核病人合并肺部混合细菌感染者的痰培养及药敏结果进行分析。结果：痰标本共分离出126株细菌，革兰氏阴性菌89株（70．6％），前三位分别为：克雷伯菌属30株（33．7％），铜绿假单胞菌13株（14．6％），大肠埃希菌9株（10．1％）：革兰氏阳性菌37株（29．4％），前三位分别是：葡萄球菌15株（40．5％），表皮葡萄球菌10株（27．0％），金黄色葡萄球菌5株（13．5％）。耐药分析：克雷伯菌属、肠杆菌科。、铜绿假单胞菌对亚胺培南的耐药率为0％～3．3％，对哌拉西林、头孢他定、头孢吡肟、阿米卡星、妥布霉素及环丙沙星的耐药率变化较大，为7．7％～57．7％。3种葡萄球菌对青霉素的耐药率为100％．对庆大霉素、红霉素、苯唑西林及磺胺的耐药率为80％～100％，对万古霉素均敏感。结论：肺结核合并肺部混合细菌感染者，其病原菌以革兰氏阴性菌为主，亚胺培南除对单胞菌属敏感率为71．4％以外，对其他杆菌的敏感率93％～100％，革兰氏阴性杆菌对其他抗生素的耐药率变化较大；革兰氏阳性菌对青霉素类、红霉素、庆大霉素、新诺明耐药率极高（80％～100％）。临床用药时需要了解本地区细菌耐药状况，应根据药敏结果合理、科学的选用抗生素。
Objective：To understand the bacteria and drug resistance for pulmonary tuberculosis complicated pulmonary mixed bacterial infection, discussing how to choice antibiotic in experience uses for this kind of patient. Methods： The trend of sputum culture and drug sensitivities was analysed for inpatient pulmonary tuberculosis complicated pulmonary mixed bacterial infection. Results： The 126 bacteria were separated from sputum samples;most of which were G-germs 89 cases（70.6 % ）, the top three were： Klebsiella 30 cases（33.7 % ）, Pseudomonas aeruginosa 13 cases （ 14.6 %）, Escherichia coli 9 cases （ 10.1%）; G^＋ germs were 37 cases （29.4 % ）, the top three were： staphylococci 15 cases （40.5 % ）, staphylococcus epidermidis 10 cases （27.0 % ）, staphylococcus aureus 5 cases（13.5 % ）.Analyzing the trend of drug resistance, in the rate of drug resistance, Klebsiella, Enterobacteriaceae, Pseudomonas aeruginosa to imipenem were 0%～3.3%, to piperacillin, ceftazidime, cefepime, amikacin tobramycin and ciprofloxacin were 7.7% ～57.7% ;The drug resistance of main staphylococci, to penicillin were 100%, to gentamicin erythromycin, oxacillin and sulfadrug were 80% 100%, to vancomycin were sensitive. Conclusions： The cases sufferd from pulmonary tuberculosis complicated pulmonary mixed bacterial infection, the main pathogens were G- bacteria. In antimicrobial sensitivity, imipenem to aeromonas was 71.4%, to other Bacilli was 93% ～100%, G^- bacteria to other antibiotics were larger changes; G^＋ bacteria to penicillin, erythromycin, gentamicin and trimoxazole were rather high （80 % ～ 100 %） . When antibiotics are used, the need to be aware of drug resistance situation in the region,hospital and department, should be based on antimicrobial sensitivity results rational, scientific selection of antibiotics.
出处
《内蒙古医学杂志》
2008年第1期52-54,共3页
Inner Mongolia Medical Journal
关键词
结核
病原菌
耐药性
Tuberculosis
Pathogenic bacteria
Drug resistance
