摘要
目的探讨老年肺结核患者肺部感染的病原菌分布特点及耐药性,为指导临床合理使用抗菌药物提供参考依据。方法选取2014年1月-2015年6月医院肺结核发生肺部感染的老年患者173例,分析其痰液标本分离培养出的病原菌及耐药性,数据采用SPSS 17.0软件进行统计分析。结果 173例肺结核合并肺部感染患者共分离出215株病原菌,以革兰阴性菌为主,共143株占66.51%;铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌、大肠埃希菌对磺胺甲噁唑/甲氧苄啶耐药率较高,均>70.00%;金黄色葡萄球菌、肺炎链球菌、溶血葡萄球菌对青霉素耐药率较高,均>85.00%;白色念珠菌、热带念珠菌、光滑念珠菌对两性霉素B、氟康唑、氟胞嘧啶的耐药率均为0。结论老年肺结核合并肺部感染的致病菌以革兰阴性菌为主,真菌感染所占比重也呈明显上升趋势,因此临床用药应根据药敏试验结果,合理选择抗菌药物。
OBJECTIVE To investigate the pathogenic bacteria distribution and drug resistance of pulmonary infection in elderly patients with pulmonary tuberculosis,in order to provide evidence for clinical rational use of antibiotics.METHODS A total of 173 cases of elderly patients with pulmonary tuberculosis and pulmonary infection in our hospital from Jan.2014 to Jun.2015 were selected,whose sputum specimens were isolated and detected and the pathogenic bacteria were under analysis of situation and drug resistance.SPSS 17.0was used for data analysis.RESULTS A total of 215 strains of pathogenic bacteria were isolated from the 173 patients with pulmonary tuberculosis and pulmonary infection,mainly gram-negative bacilli with 143 strains,accounting for 66.51%.The drug resistance rates of Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii and Escherichia coli to sulfamethoxazole/trimethoprim were all in high level,all〉70.00%.The drug resistance rates of Staphylococcus aureus,Streptococcus pneumoniae and Staphylococcus haemolyticus to penicillin were in a high level,all〉85.00%.The drug resistance rates of Candida albicans,Candida tropicalis and Candida glabratato amphotericin B,fluconazole and flucytosine were all 0.CONCLUSIONThe main pathogenic bacteria of pulmonary tuberculosis complicated with pulmonary infection in elderly patients are gram negative bacilli,and the proportion of fungal infection is also a significant upward trend.Therefore,clinical medication should be based on drug sensitivity test results,and make reasonable choice of antimicrobial agents.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第16期3657-3659,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(2014ZRB14578)
关键词
老年肺结核
肺部感染
菌群分布
药敏试验
Elderly pulmonary tuberculosis
Pulmonary infection
Bacterial flora distribution
Drug sensitivity test
