摘要
目的探讨肺结核并发肺部其他病原菌感染患者的菌种分布及其耐药性，提高临床治疗肺结核并发其他病原菌感染的疗效。方法选择2011年3月至2015年12月中山市第二人民医院已确诊1025例的肺结核患者的痰标本共分离1043株其他病原菌。患者中男性768例（74．9％），女性257例（25．1％），其中〈60岁患者有415例，≥60岁患者有610例，多种病原菌重叠感染18例。1043株临床分离的其他病原菌采用美国BD公司的PHOENIX-100型全自动微生物鉴定仪进行菌种鉴定及药物敏感性试验（简称“药敏试验”）。所得药敏试验数据采用WHONET5．4版软件进行统计及分析。结果1043株病原菌中，革兰阴性菌占83．3％（869／1043），革兰阳性菌占11．2％（117／1043），真菌占5．5％（57／1043）。并发革兰阴性菌感染前5位的菌种为：铜绿假单胞菌，占24．8％（259／1043）；鲍曼不动杆菌，占16．9％（176／1043）；肺炎克雷伯菌，占16．8％（175／1043）；嗜麦芽窄食单胞菌，占8．4％（88／1043）；大肠埃希菌，占7．4％（77／1043）。革兰阳性菌感染以凝固酶阴性葡萄球菌（6．0％，63／1043）和金黄色葡萄球菌（4．1％，43／1043）为主；对苯唑西林耐药的细菌前者达100．oH（63／63），后者达67．4％（29／43）；未发现耐万古霉素的葡萄球菌。真菌感染以白色假丝酵母菌（3．8％，（40／1043）为主。药敏试验结果显示：铜绿假单胞菌对美罗培南（10．8％，28／259）、阿米卡星（3．5％，9／259）、庆大霉素（9．3％，24／259）等耐药率低；鲍曼不动杆菌对阿米卡星（46．0％，81／176）、亚胺培南（45．5％，80／176）和美罗培南（47．7％，84／176）耐药率低；肺炎克雷伯菌和大肠埃希菌对抗生素药物的敏感率大致相同，均对碳青霉素类最敏感，美罗培南的耐药率分别是（3．4％，6／175）和（3．
Objective To investigate the distribution and drug resistance character of pathogenic microorganism in patients of pulmonary tuberculosis complicated with pneumonia and to improve their curative effect Methods Of 1025 cases of tuberculosis patients hospitaled Select from March 2011 to December 2015 were selected and 1043 pathogens microorganism were isolated. There were 768 males （74. 9%） and 257 females （25.1%）. Among them, 415 patients were 〈60 years old, 610 patients were ≥60 years old, and 18 patients were infected with multiple pathogens. Bacteria identification and drug sensitivity test （DST） were done by the United States BY） Company PHOENIX-100 Automatic microbiological identification in 1043 clinical isolates. The data of DST was analyzed by WHONET 5. 4 software. Results Among the 1043 pathogens, There were 83. 3% （869/1043） gram- negative bacilli, 11.2% （117/1043） Gram-positive cocci, and 5.5% （57/1043） Fungal. The top five strains of Gram-negative bacilli were as follows： Pseudomonas aeruginosa, was 24.8 % （259/1043）; Acinetobacter baumannii was 16.9% （176/1043）; Klebsiella pneumoniaewas 16.8% （175/1043）; Stenotrophomonas maltophilia,was 8.4% （88/1043） ; Escherichia coli, was 7.4% （77/1043）. Coagulase-negative staphylococci （6.0%, 63/1043） which were 100. 0% （63/63） prednisone-resistant, and Staphylococcus aureus （4.1%, 43/1043） which were 67.4% （29/43） prednisone-resistant were predominant in Gram-positive cocci; vancomycin-resistant staphylococci were not found. Of 3.8% （40/1043） fungal infection were Candida albicans. DST showed： Pseudomonas aeruginosa had low resistance rates to meropenem （10.8%, 28/259）, amikacin （3.5%, 9/259） and gentamicin （9.3%, 24/259）. The resistance rate of Acinetobacter baumannii to amikacin （46.0%, 81/176）, imipenem （45.5%, 80/176） and mero- penem （47.7%, 84/176） was low. The resistance rates of meropenem in Klebsiella pneumoniae and Escherichia coli were （3.4%, 6/175） and
出处
《中国防痨杂志》
CAS
2017年第8期845-850,共6页
Chinese Journal of Antituberculosis
关键词
结核
肺
重叠感染
抗药性
细菌
微生物敏感性试验
数据说明
统计
Tuberculosis, pulmonary
Mixed infection
Drug resistance, bacterial
Microbial sensitivity test
Data interpretation, statistical
