摘要
目的:了解和探讨肺结核患者合并感染呼吸道细菌的分布状况及耐药情况。方法:笔者对2005年2月至2007年2月期间141例肺结核患者的痰液进行细菌培养及药敏试验,并统计分析。结果:检测到的G+菌占12.8%,G-菌占67.4%,最常见的细菌依次是:肺炎克雷伯菌、真菌、铜绿假单胞菌、大肠埃希氏菌、流感嗜血杆菌、肺炎链球菌。多数细菌对头孢哌酮/舒巴坦都高度敏感,G-杆菌对万古霉素高度敏感,头孢噻肟、庆大霉素、环丙沙星、阿米卡星、左旋氧氟沙星对G+和G-菌均有较强的广谱抗菌作用,氨苄青霉素、复方新诺明、克林霉素、罗红霉素耐药率较高,青霉素G完全不敏感。克雷伯菌属的超广谱β-内酰胺酶(ESBLS)的发生率达37.5%,未发现MRSA对万古霉素耐药。结论:肺结核患者合并感染呼吸道细菌的构成以G-杆菌多见,具有较高的耐药性,应引起重视,建议临床医生根据药敏结果选择合理的抗生素。
Objective：To study the distribution and drug - resistance of the pathogens in the tuberculo- sis sufferers who merger infection breath way bacteria. Method：The pathology analysis and the drug sensitivity test were done for the phlegm of 141 cases from the tuberculosis sufferers from Feb. 2005 to Feb. 2007 . Result ：The main pathogens were Gram - negative bacteria （ 67.4% ） . The number of Gram - positive organisms was 12.8 % . Among them.from high to low.the pathogens in turn is： Klebsiella pneumoniae,fungus,Pseudomonsa aeruginosa ,Escherichia coli,Haemophilus influenzae ,Streptococcus pneumoniae. Most of pathogens is susceptive to Cefoperazone/Sulbactam. Gram - negative bacteria is susceptive to Vancomycin. Gram - negative bacteria and Gram - positive organisms both showed the drug - resistant rate is belower to Cefotaxime Sodium, Gentamycin, Ciprofloxacin, Amikacin, Levofloxacin ; and showed the drug - resistant rate is higher to Ampicillin,SMZ ＋ TMP,Clindamycin,Roxithromyein;and showed the drug- resistant rate 100% to penicillin G. The rate of extended spectrum beta- lactamases（ESBLs） of Klebsiellai is 37.5%. MRSA showed the drug - resistant rate 0% to Vancomycin. Conclusion ： Gram - negative bacteria were very promi- nent in pathogens of tuberculosis sufferers who merger infection breath way bacteria . The antibiotics should be used reasonably .which can reduce the development of drug - resistant strains.
出处
《河北医学》
CAS
2009年第6期683-685,共3页
Hebei Medicine
关键词
肺结核
痰液
耐药性
抗生素
Tuberculosis
Phlegm
Drug - resistant
Antibiotic
