J4 ›› 2011, Vol. 10 ›› Issue (6): 36-38.

• 临床医学 • 上一篇    下一篇

肺结核并下呼吸道感染489株病原菌的分布及耐药性分析

  

  1. 昆明市第三人民医院,昆明 650041
  • 出版日期:2011-06-01 发布日期:2011-06-01
  • 作者简介:黄丽萍,主管护士,主要从事传染病护理研究.

Pathogens in Pulmonary Tuberculosis Complicated Low Respiratory Tract Infection:The Distribution and Antimicrobial Resistance Analysis of 489 Strains

  1. The Third People s Hospital of Kunming,Kunming,650041,China
  • Online:2011-06-01 Published:2011-06-01

摘要:

目的:调查我院肺结核并下呼吸道感染病人痰液标本中临床分离病原菌的分布及耐药状况,以指导合理用药。方法:对我院近两年来肺结核并下呼吸道感染病人1 321份痰液标本分离的病原菌进行回顾性分析。结果:共检出489株致病菌,其中革兰阳性菌184株,占37.6%,主要有表皮葡萄球菌、粪肠球菌、链球菌属、金黄色葡萄球菌;革兰阴性菌169株,占34.6%,主要有大肠埃希氏菌、醋酸钙不动杆菌、假单胞菌属、克雷伯菌属;真菌136株,占27.8%,多为为白色念珠菌。药敏结果(除真菌)显示:大多数革兰氏阳性菌及阴性菌对多种抗生素耐药,耐药率较高的抗生素依次为苯唑西林、克林霉素、磺胺甲恶唑、红霉素、万古霉素、青霉素钠、环丙沙星、左氧氟沙星;仍具有较高敏感率的依次为亚胺培南、头孢吡肟、阿米卡星、妥布霉素、头孢噻肟钠、头孢曲松钠、头孢哌酮钠。结论:肺结核病并下呼吸道感染的细菌多为条件致病菌,且具有多重耐药性,临J宋上应加强监测,根据药敏结果合理使用抗生素。目的:调查我院肺结核并下呼吸道感染病人痰液标本中临床分离病原菌的分布及耐药状况,以指导合理用药。方法:对我院近两年来肺结核并下呼吸道感染病人1 321份痰液标本分离的病原菌进行回顾性分析。结果:共检出489株致病菌,其中革兰阳性菌184株,占37.6%,主要有表皮葡萄球菌、粪肠球菌、链球菌属、金黄色葡萄球菌;革兰阴性菌169株,占34.6%,主要有大肠埃希氏菌、醋酸钙不动杆菌、假单胞菌属、克雷伯菌属;真菌136株,占27.8%,多为为白色念珠菌。药敏结果(除真菌)显示:大多数革兰氏阳性菌及阴性菌对多种抗生素耐药,耐药率较高的抗生素依次为苯唑西林、克林霉素、磺胺甲恶唑、红霉素、万古霉素、青霉素钠、环丙沙星、左氧氟沙星;仍具有较高敏感率的依次为亚胺培南、头孢吡肟、阿米卡星、妥布霉素、头孢噻肟钠、头孢曲松钠、头孢哌酮钠。结论:肺结核病并下呼吸道感染的细菌多为条件致病菌,且具有多重耐药性,临J宋上应加强监测,根据药敏结果合理使用抗生素。

关键词: 肺结核, 下呼吸道感染, 病原菌, 耐药分析

Abstract:

lAbstract]Objective:To investigate the distribution and antimicrobial resistanee of sputum samples from patients with pulmonary tuberculosis combined with lower respiratory tract infection in our hospital to guide a rational use of drugs.Methods:Pathogens isolated from 1 32 1 sputum samples from patients with pulmonary tuberculosis and lower respiratmT tract infection in our hospital in the last two years were analyzed retrospectively.Results:Four hundred and eighty—nine pathogens were detected in 1 32 1 samples, including 1 84 (37.6% )strains of gram—positive bacteiia,which were mainly Staphylococcus epidermidis,Enterococcus faecalis.Streptococcus and Staphylococcus aureus;1 69 (34.6% )strains ofgram—negative bacteria,which were mainly Escherichia coli,calcium acetate Acinetobacter.Pseudomouas and Klebsiella;1 36 (27.8% )strains of fungi.Ⅲost of which were Candida albicans.Drug susceptibility results(except
fungi j showed that most gram—positive and gram-negative bacteria were resistant to a variety of antibiotics.And the antibiotics with higher resis tance rates were:oxacillin,clindamycin,sulfamethoxazole,erythromycin,vaneomycin,penicillin sodium,ciprofloxacin, levofloxacin;relatively higher sensitive antibiotics were imipenem,cefepime,amikacin,tobramycin,cefotaxime sodium ,cefiriaxone
sodium,cefoperazone sodium.Conclusion:Pathogens in puhnonary tuberculosis and bacterial lower respiratory tract infection were mostly opportunistic pathogens,which were with nmhiple dru g resistance.Rational USe of antibiotics based on drug susceptibility results and clinical monitoring should be strengthened.

Key words: pulmonary tuberculosis, lower respiratory tract infelction, pathogens, antimicrobial resistance analysis

中图分类号: