摘要
目的分析肺结核继发其他病原菌肺部感染的病原菌特征及耐药性。方法2019年1月至2021年5月莆田学院附属医院收治的320例肺结核继发其他病原学肺部感染患者作为研究对象,取所有患者的痰液或肺泡灌洗液样本进行痰培养,并展开药敏试验。结果320例患者共分离96株病原菌,病原菌分布为革兰阴性菌占比58.33%、真菌占比28.13%和革兰阳性菌占比13.54%。革兰阳性菌以金黄色葡萄球菌和表皮葡萄球菌最常见,对哌拉西林、庆大霉素、左氧氟沙星的耐药性最高,对多粘菌素B、美罗培南和亚胺培南的耐药性低;革兰阴性菌以肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和大肠埃希菌最常见,对青霉素、苯唑西林、红霉素的耐药性最高,对万古霉素、利奈唑胺和替加环素的耐药性低;真菌以白假丝孝母菌最常见,对酮康唑、氟康唑的耐药性最高,对两性霉素和伏立康唑的耐药性低。结论导致肺结核继发肺部感染的病原菌种类多,需开展病原学检查,并以药敏试验结果为参考合理的选择药物,以确保临床治疗有效性及用药安全性。
Objective To analyze the pathogen characteristics and drug resistance of pulmonary infection secondary to pulmonary tuberculosis.Methods 320 patients with pulmonary tuberculosis secondary to other pathogenic pulmonary infections were treated in the Affiliated Hospital of Pu-tian University from January 2019 to May 2021 as research subjects,sputum or alveolar lavage fluid samples from all patients were collected for spu-tum culture and drug susceptibility test was carried out.Results A total of 96 strains of pathogenic bacteria were isolated from 320 patients,patho-genic bacteria distribution:Gram-negative bacteria accounted for 58.33%,fungi accounted for 28.13%and Gram-positive bacteria accounted for 13.54%.Staphylococcus aureus and Staphylococcus epidermidis were the most common gram-positive bacteria,and the resistance to piperacillin,gentamicin and levofloxacin was the highest,while the resistance to polymyxin B,meropenem and imipenem was low.The most common gram-nega-tive bacteria were Klebsiella pneumoniae,pseudomonas aeruginosa,Acinetobacter baumannii and Escherichia coli.The resistance to penicillin,oxa-cillin and erythromycin was the highest,while the resistance to vancomycin,linezolid and tigacycline was low.The fungal resistance to ketoconazole and fluconazole was the highest,and the resistance to amphotericin and voriconazole was low.Conclusion There are many kinds of pathogenic bac-teria leading to pulmonary infection secondary to tuberculosis,so it is necessary to carry out etiological examination,and choose drugs reasonably based on the results of drug sensitivity test to ensure the effectiveness of clinical treatment and drug safety.
作者
吴良宁
林群英
林国盛
WU Liangning;LIN Qunying;LIN Guosheng(Pulmonary and Critical Care Medicine,Affiliated Hospital of Putian University,Fujian,Putian,351100,China)
出处
《当代医学》
2024年第7期123-126,共4页
Contemporary Medicine
基金
福建省自然科学基金(2018J01196)
莆田市科技计划项目(2019SZP02)。
关键词
肺结核
肺部感染
病原菌
耐药性
Pulmonary tuberculosis
Pulmonary infection
Pathogenic bacteria
Drug resistance
