摘要
目的了解肺结核合并呼吸系统细菌感染的病原菌构成及其耐药性分析。方法对住院肺结核合并呼吸系统非结核分枝杆菌感染的病人取合格痰标本进行普通细菌培养及药物敏感试验分析。结果痰标本中共分离出607株细菌。革兰阴性杆菌423株(69.7%),前3位分别是:氧化酶阳性的非发酵菌151株、克雷伯菌属112株、肠杆菌属48株;革兰阳性球菌184株,其中凝固酶阳性53例,凝固酶阴性131例。耐药分析:葡萄球菌对青霉素的耐药率高达80%以上,对红霉素,阿奇霉素,克林霉素,环丙沙星、氧氟沙星耐药率超过60%,对万古霉素均敏感,替考拉林敏感率超过90%。革兰阴性杆菌对阿米卡星耐药率相对较低(18.4%～30%),第3、4代头孢菌素,喹诺酮类药物对发酵菌的耐药率均达50%或以上;头孢他啶、头孢吡肟对非发酵类敏感率较高(62.5%、81,6%),亚胺培南、美诺培南及酶抑制剂对革兰阴性杆菌耐药率较低,敏感性超过80%,其中亚胺培南耐药率为0。结论肺结核合并细菌感染及耐药情况较严重,建议及时进行痰细菌培养,结合药物敏感试验结果合理选择抗生素,避免不合理的用药,增加耐药的的几率。
Objective To understand the pulmonary tuberculosis with respiratory system bacterial infection and to analyze pathogens and drug resistance.Methods Qualified sputum specimens were collected for the general bacterial culture and drug sensitivity analysis.Results Sputum specimens were isolated from 607 strains of bacteria.There were Gram negative bacilli 423 isolates（69.7%）,the top three were oxidase positive non fermentative bacteria strain 151,112 strains of Klebsiella,48 strains of Enterobacter;184 Gram-positive cocci,of which coagulase positive in 53 cases,131 cases of coagulase-negative.Analysis of drug resistance of Staphylococcus to penicillin showed higher resistance rate amounts to 80% and above,erythromycin,azithromycin,clindamycin,ciprofloxacin,ofloxacin resistance rates to vancomycin over 60%,for teicoplanin there was a sensitive rate of more than 90%.Gram negative bacillus on amikacin resistance rate was relatively low（18.4%～30%）,3-generation,4-generation cephalosporins,quinolones on fermentative bacteria resistance rate reached 50% or above;ceftazidime,cefepime on non-fermentable sensitive rate（62.5%,81,6%）,imipenem,meropenem and enzyme inhibitors on Gram-negative bacillus drug resistance rate was low,with a sensitivity of more than 80%,of which imipenem resistance rate being 0.Conclusion Pulmonary tuberculosis complicated with bacterial infection and drug resistance situation is rather serious,which suggest timely sputum bacteria culture,drug sensitive test,combined with reasonable choice of antibiotics,to avoid irrational drug use and increased drug resistance rate.
出处
《安徽医药》
CAS
2013年第1期93-95,共3页
Anhui Medical and Pharmaceutical Journal
关键词
肺结核
细菌感染
耐药
pulmonary tuberculosis
bacterial infection
drug resistance
