摘要
目的分析肺结核患者继发下呼吸道感染的病原菌分布及耐药性,为临床合理用药提供依据。方法随机选取医院2009年2月-2012年3月收治的185例肺结核继发下呼吸道感染患者作为研究对象,回顾性分析病原菌检测及耐药性结果。结果共分离出病原菌185株,其中革兰阴性菌117株占63.3%,革兰阳性菌40株占21.6%,真菌28株占15.1%,排名前3位依次为铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌,分别占25.4%、15.1%、14.6%;氨苄西林是目前肺结核继发下呼吸道感染敏感率最高的药物,铜绿假单胞菌敏感率为100.0%,金黄色葡萄球菌敏感率为92.9%,肺炎克雷伯菌敏感率为96.3%,大肠埃希菌敏感率为94.4%。结论肺结核继发下呼吸道感染以革兰阴性菌感染率为主,氨苄西林是目前肺结核继发下呼吸道感染敏感率最高的药物,进行致病菌检测及药敏试验有利于提高临床治疗方案的合理性,改善治疗效果以及安全性。
OBJECTIVE To analyze the distribution and drug resistance of the pathogenic bacteria causing secondary lower respiratory tract infections in tuberculosis patients so as to provide basis for the rational use of antibiotics in clinic. METHODS A total of 185 cases of pulmonary tuberculosis patients with lower respiratory tract infections who received treatment from Feb 2009 to Mar 2012 were selected as research objects, then the isolation of pathogens and thedrug resistance were retrospectively analyzed. RESULTS Totally 185 strains of pathogens were isolated, among Which there were 117 （63.3%） strains of gram-negative bacteria,40 （21.6%） strains of grampositive bacteria, and 28 （15. 1%） strains of fungi. Pseudornonas aeruginosa （25.4 %）, Staphylococcus aureus （15. 1%）, KlebsieIla pneumoniae （14. 6%） ranked the top three species of pathogens. The ampicillin was the most sensitive drug to treat the secondary lower respiratory tract infections in pulmonary tuberculosis patients, the susceptibility rates to P. aeruginosa, S. aureus, K. pneumoniae, and l%scherlchia coli were 100%, 92. 9%, 96.3%/%, and 94. 4%/%, respectively. CONCLUSION The gram-negative bacteria are the main pathogenic bacteria causing secondarylower respiratory tract infections in pulmonary tuberculosis patients, ampicillin is the most sensitive drug to treat the secondary lower respiratory tract infections. The detection of pathogens and drug susceptibility testing can contribute to the improvement of the rationality of clinical treatment program, therapeutic effect as well as safety.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第22期5577-5579,共3页
Chinese Journal of Nosocomiology
基金
宁波市优秀中青年卫生技术人才基金资助项目(2011-145)
宁波市领军和拔尖人才培养工程基金资助项目(2012-131)
关键词
肺结核
呼吸道感染
病原菌
耐药性
Tuberculosis
Respiratory tract infection
Pathogenic bacteria
Drug resistance
