2013年—2015年住院肺结核患者下呼吸道革兰阴性菌分布及耐药性分析

发布时间：2018-12-05 19:41

【摘要】：目的探讨结核合并下呼吸道感染住院患者痰培养的革兰阴性菌构成特点和耐药情况变迁,为临床合理使用抗菌药物提供科学依据。方法对2013年—2015年住院结核患者送检的合格痰标本进行常规细菌分离培养,培养阳性结果用VITEK-2 Compact全自动微生物分析仪进行细菌鉴定及药敏试验。结果共分离出革兰阴性菌1229株,革兰阴性菌前5位依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌和鲍曼不动杆菌,其中前两者对大多数抗菌药物的耐药率均在50%以下,对革兰阴性菌敏感率高的抗生素是头孢吡肟、哌拉西林/他唑巴坦、氨基糖苷类、亚胺培南等。结论革兰阴性菌感染率以及耐药率的逐渐增高应当引起足够的警惕,加强临床病原菌及其耐药性的监测,对于临床合理使用抗菌药物,有效治疗结核患者下呼吸道感染以及减缓耐药菌株的产生具有重要意义。
[Abstract]:Objective to investigate the characteristics of Gram-negative bacteria in sputum culture of patients with tuberculosis complicated with lower respiratory tract infection and the changes of drug resistance, so as to provide scientific basis for rational use of antimicrobial agents in clinic. Methods the qualified sputum samples from TB patients in our hospital from 2013 to 2015 were isolated and cultured. The positive results were identified by VITEK-2 Compact automatic microbiological analyzer and drug sensitivity tests were carried out. Results 1229 strains of Gram-negative bacteria were isolated, the top 5 were Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae and Acinetobacter baumannii. The first two antibiotics were resistant to most antibiotics less than 50%. The antibiotics with high sensitivity to Gram-negative bacteria were cefepime, piperacillin / tazobactam, aminoglycosides, imipenem, and so on. Conclusion the increasing rate of Gram-negative bacteria infection and drug resistance should arouse sufficient vigilance, strengthen the monitoring of clinical pathogens and their drug resistance, and make rational use of antimicrobial agents in clinic. It is important to treat lower respiratory tract infection in tuberculosis patients and to slow down the production of drug resistant strains.
【作者单位】：天津市海河医院检验科国家中医药管理局中医药防治传染病重点研究室;
【分类号】：R446.5;R521

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