摘要
目的 探讨煤工尘肺合并肺炎的病原菌分布及耐药性,为早期指导临床合理使用抗菌药物提供科学依据.方法 选择宁波市第一医院呼吸科和宁波市第二医院肺科201 1年6月至2014年6月期间收治的76例煤工尘肺合并肺炎患者为研究对象,无菌收集痰标本进行细菌培养,并进行药敏试验.结果 76例患者送检痰标本245例次,经细菌学检验共分离出218株病原菌,其中革兰阴性杆菌（G^-）163株,占74.77％;革兰阳性球菌（G^＋）39株,占17.89％;真菌16株,占7.34％.主要革兰阴性杆菌对阿莫西林/克拉维酸、氨苄西林、复方磺胺甲唑、头孢噻肟、氨曲南等耐药率高,对阿米卡星、亚胺培南、美罗培南敏感;主要革兰阳性球菌对青霉素、红霉素、阿莫西林/克拉维酸、氨苄西林、头孢噻肟、克林霉素等耐药率高,对万古霉素、替考拉宁敏感.结论 该组煤工尘肺合并肺炎病例的主要病原菌为革兰阴性杆菌,临床上常用的抗菌药物多有严重的耐药性,应掌握好病原菌的分布及其耐药性,根据药敏试验结果合理选择抗菌药物.
Objective To investigate the pathogen distribution and drug resistance in coal workers＇ pneumoconiosis associated with pneumonia and to provide a scientific basis for early guidance for rational clinical application of antibacterial agents.Methods Seventy-six patients with coal workers＇ pneumoconiosis associated with pneumonia who were admitted to our hospital from June 2011 to June 2014 were enrolled as subjects.The sputum specimens were aseptically collected for bacterial culture and drug sensitivity tests.Results In 245 sputum specimens collected from 76 patients,a total of 218 strains of pathogens,including 163 strains of Gram-negative bacilli （74.77%）,39 strains of Gram-positive cocci （17.89%）,and 16 strains of fungi （7.34%） were isolated by bacteriological tests.The main Gram-negative bacilli had high rates of resistance to amoxicillin/clavulanic acid,ampicillin,cotrimoxazole,cefotaxime,and aztreonam,and were sensitive to amikacin,imipenem,and meropenem.The main Gram-positive cocci had high rates of resistance to penicillin,erythromycin,amoxicillin/clavulanic acid,ampicillin,cefotaxime,and clindamycin,and were sensitive to vancomycin and teicoplanin.Conclusion The main pathogens in these patients with coal workers＇ pneumoconiosis associated with pneumonia are Gram-negative bacilli,which are highly resistant to common clinically used antibacterial agents.The pathogen distribution and drug resistance should be well understood,and the antibacterial agents should be rationally selected according to the results of drug sensitivity tests.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
2015年第2期129-131,共3页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
尘肺
肺炎
病原菌
抗药性
Pneumoconiosis
Pneumonia
Pathogen
Drug resistance
