支气管扩张合并感染患者纤维支气管镜下支气管分泌物病原菌培养及耐药性分析

发布时间：2018-01-13 18:41

本文关键词：支气管扩张合并感染患者纤维支气管镜下支气管分泌物病原菌培养及耐药性分析　出处：《中国感染与化疗杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨支气管扩张合并感染患者纤维支气管镜下支气管分泌物培养病原菌分布及耐药情况,为合理选择抗菌药物治疗提供参考。方法选取2013年6月-2015年12月华中科技大学同济医学院附属梨园医院呼吸内科住院的支气管扩张合并感染患者97例,收集纤维支气管镜下支气管分泌物标本进行病原菌培养及药敏试验。结果 97例患者支气管分泌物分离病原菌53株(54.6%),其中革兰阴性杆菌49株(占92.4%),以铜绿假单胞菌为主,其次为鲍曼不动杆菌、肺炎克雷伯菌;革兰阳性菌3株(占5.7%),为金黄色葡萄球菌2株和肺炎链球菌1株;真菌1株(1.9%),为白念珠菌。药敏试验结果显示,铜绿假单胞菌对妥布霉素、阿米卡星、头孢吡肟、氨曲南敏感率较高(均70%),对左氧氟沙星耐药率最高(为100%);鲍曼不动杆菌对妥布霉素、阿米卡星敏感率较高(均为85.7%),其次对亚胺培南(42.9%);肺炎克雷伯菌对头孢噻肟、庆大霉素、环丙沙星、左氧氟沙星耐药率较高(均50%)。结论支气管扩张合并感染患者纤维支气管镜下分泌物培养病原菌以革兰阴性杆菌为主,其药敏试验结果显示对妥布霉素、阿米卡星敏感率较高,对环丙沙星、左氧氟沙星耐药率较高。研究对治疗支气管扩张合并感染患者具有重要指导意义。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in bronchiectasis complicated with infection. Methods from June 2013 to December 2015, bronchiectasis complicated by bronchiectasis in Department of Respiratory Medicine, Liyuan Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, was selected. There were 97 cases. Results 53 strains of pathogenic bacteria were isolated from bronchial secretions of 97 patients and 54.6 strains were isolated from bronchial secretions under fiberoptic bronchoscopy. Among them, 49 strains of Gram-negative bacilli (92.4%) were Pseudomonas aeruginosa, followed by Acinetobacter baumannii and Klebsiella pneumoniae. There were 3 Gram-positive bacteria (5.7%), 2 strains of Staphylococcus aureus and 1 strain of Streptococcus pneumoniae. The drug sensitivity test showed that Pseudomonas aeruginosa was sensitive to tobramycin, amikacin, cefepime and aztreonam (all 70). The resistance rate of levofloxacin to levofloxacin was the highest (100%). Acinetobacter baumannii was sensitive to tobramycin and amikacin (85.7%), followed by imipenem 42.9%; Klebsiella pneumoniae against cefotaxime, gentamicin, ciprofloxacin. The drug resistance rate of levofloxacin was high (50%). Conclusion the pathogenic bacteria of bronchiectasis complicated with infection were mainly Gram-negative bacilli cultured under fiberoptic bronchoscopy. The results of drug sensitivity test showed that tobramycin was the most sensitive to tobramycin in patients with bronchiectasis. The sensitivity rate of amikacin is higher than that of ciprofloxacin and levofloxacin. The study is of great significance for the treatment of bronchiectasis complicated with infection.
【作者单位】：华中科技大学同济医学院附属梨园医院呼吸内科;
【分类号】：R562.22;R446.5
【正文快照】： 支气管扩张是由于近端支气管壁肌肉和弹性组织受损导致支气管壁的变形、扩张而引起的一种慢性支气管疾患,常因继发下呼吸道感染反复发作而频繁使用抗菌药物。因此准确检测病原菌并依据药敏试验结果选用抗菌药物对临床治疗甚为关键。痰培养简便易行、经济、无创而成为临床常用

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