摘要
目的了解煤工尘肺合并慢性阻塞性肺疾病患者的病原菌分布及抗生素耐药情况。方法回顾性分析102例在北京市门头沟区医院住院的煤工尘肺合并慢性阻塞性肺病患者的痰培养及药敏结果。结果入选患者共送痰标本275例,培养出病原菌株212例,结果 G+菌属23株(10.85%),G-菌属159株(75%),真菌30株(14.15%),主要致病菌仍为革兰阴性杆菌,前四位为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌,革兰阴性杆菌对于亚胺培南未发现耐药,哌拉西林舒巴坦及氨基糖苷类抗菌药敏感性较好;革兰阳性菌以金黄色葡萄球菌检出率居首位,万古霉素未发现耐药,对哌拉西林舒巴坦及头孢类抗菌药耐药率低;真菌感染以白假丝酵母菌为主,对两性霉素耐药率最低。结论煤工尘肺合并慢性阻塞性肺疾病患者的呼吸道感染病原菌多为革兰阴性杆菌,常用的抗生素细菌耐药明显,提倡合理使用抗生素是防止细菌抗生素耐药的关键。
Objective To understand the distribution and drug resistance status of the pathogenic bacteria in patients with coal worker＇s pneumoconiosis（ CWP） associated with chronic obstructive pulmonary disease（ COPD）. Methods Retrospective analysis was performed on the sputum culture and drug susceptibility test results from 102 patients with CWP associated with COPD who were admitted to Beijing Mentougou Hospital. Results A total of 275 sputum specimens were collected from the enrolled patients,from which 212 pathogenic strains were isolated,including 23 Gram-positive bacterial strains（ 10. 85%）,159 Gram-negative bacterial strains（ 75%）,and 30 fungal strains（ 14. 15%）. The pathogenic bacteria were primarily Gram-negative bacilli,with Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa and Baumanii being the most common; resistance to imipenem was not detected with Gram-negative bacteria,which were susceptible to piperacillin / sulbactam and aminoglycosides; Staphylococcus aureus had the highest detection rate among the Gram-positive bacteria,which were detected with no resistance to vancomycin and low resistance rates to piperacillin / sulbactam and cephalosporins; the fungal infection was primarily caused by Monilia albicans,which had the lowest resistance rate to amphotericin.Conclusion The pathogenic bacteria for CWP associated with COPD are mostly Gram-negative bacilli. There is significant bacterial resistance to the commonly used antibiotics. It is essential to prevent bacterial resistance to antibiotics to promote rational use of antibiotics.
出处
《首都医科大学学报》
CAS
北大核心
2016年第4期486-490,共5页
Journal of Capital Medical University
基金
国家科技部重大项目(Z013ZX09102026)~~
关键词
尘肺
慢性阻塞性肺疾病
抗菌药
细菌抗生素耐受性
pneumoconiosis
chronic obstructive pulmonary disease
antimicrobials
bacterial antibiotic resistance
