摘要
目的探讨复治肺结核合并重症肺炎患者的耐药性及相关干预对策。方法选取76例复治肺结核并发重症肺炎患者,均接受痰液细菌培养、药敏试验检测,对病原菌分布、耐药性结果进行分析。结果痰液细菌培养共培养出147株病原菌,其中34株为真菌,47株为革兰阳性杆菌,66株为革兰阴性杆菌。真菌对酮康唑、氟康唑的耐药性最强,而对两性霉素B无显著耐药性。革兰阳性杆菌对青霉素C、四环素、庆大霉素、氨苄西林、阿米卡星、妥布霉素、苯唑西林存在强耐药性(>80%),对替考拉宁及利奈唑胺的耐药性表现较低。革兰阴性杆菌对头孢唑林、氨苄西林、阿莫西林/克拉维酸、头孢噻肟、氨苄西林/舒巴坦、氨曲南、左氧氟沙星、环丙沙星存在高耐药性(≥80.0%),对美洛培南、及亚胺培南、多黏菌素的耐药性表现较低。结论复治肺结核并发重症肺炎的主要病原菌为革兰阴性杆菌,而革兰阳性杆菌、革兰阴性杆菌对临床常用抗生素存在较高的耐药性。
Objective To investigate the drug resistance of retreated pulmonary tuberculosis patients complicated with severe pneumonia and the relevant intervention measures. Methods Total- ly 76 retreated pulmonary tuberculosis patients complicated with severe pneumonia were examined by sputum culture and drug sensitivity test. The distribution and drug resistance of pathogens were ana- lyzed. Results Totally 147 strains of pathogenic bacteria were cultivated in the sputum culture, in which 34 strains were fungi, 47 strains were Gram-positive and 66 strains were gram-negative bacilli. The resistance of fungi to ketoconazole and fluconazole was the strongest, but there was no significant resistance to amphotericin B. The resistance of Gram positive bacteria to penicillin C, ampicillin, tet- racycline, gentamicin, Amikacin, tobramycin, oxacillin resistance was strong （ 〉 80% ）, resistant to teicoplanin and linezolid was low. The resistance of Gram negative bacilli to cefazolin, ampicillin, amoxicillin/clavulanic acid, cefotaxime, ampicillin/sulbactam, aztreonam, levofloxacin and cipro- floxacin were high （more than 80% ） , and resistance to meropenem, imipenem, and colistin was low. Conclusion Gram negative bacilli are the main pathogens of retreated pulmonary tuberculosis patients complicated with severe pneumonia, and Gram-positive bacilli and Gram-negative bacilli are highly resistant to commonly used antibiotics.
出处
《实用临床医药杂志》
CAS
2018年第5期45-48,共4页
Journal of Clinical Medicine in Practice
关键词
复治肺结核
重症肺炎
耐药性
干预对策
retreated pulmonary tuberculosis
severe pneumonia
drug resistance
inter- vention countermeasures
