诺卡菌培养阳性病例临床特点分析

发布时间：2018-12-21 08:00

【摘要】：目的对诺卡菌培养阳性病例的临床特点进行分析,提高对诺卡菌病的认识。方法回顾性分析宁夏医科大学总医院2012年5月至2016年5月住院患者标本培养为诺卡菌阳性的患者的临床资料。结果20例诺卡菌培养阳性病例中3例考虑污染所致,其余17例为不同部位感染,其中2例为播散性感染,12例为肺部感染,2例为软组织感染,1例为透析相关性腹膜炎;17例均合并基础疾病,其中7例因基础病使用糖皮质激素或免疫抑制剂。17例中2例死亡,余15例经复方新诺明、米诺环素、阿米卡星、美罗培南、三代头孢等治疗后病情好转出院;随访9例痊愈,其中5例口服复方新诺明片联合或不联合米诺环素片治疗6个月到15个月不等,4例病情反复,其中3例合并支气管扩张,2例失访。结论诺卡菌可引起全身各部位感染,以肺为常见。有基础疾病者易发生诺卡菌感染,尤其使用糖皮质激素及免疫抑制剂患者。诺卡菌病无特异临床表现。治疗一线药物为磺胺类,氨基糖苷类、三代头孢等亦为可选药物。诺卡菌病的预后感染部位、有否基础疾病、治疗及时否等因素有关。
[Abstract]:Objective to analyze the clinical characteristics of positive cases of Nocardial bacilli culture and to improve the understanding of Nocardiosis. Methods the clinical data of Nocardial bacillus positive specimens cultured from May 2012 to May 2016 in General Hospital of Ningxia Medical University were analyzed retrospectively. Results among the 20 cases of positive culture of Nocardial bacillus, 3 cases were caused by contamination, the other 17 cases were infected by different sites, 2 cases were disseminated infection, 12 cases were pulmonary infection, 2 cases were soft tissue infection, and 1 case was dialysation-associated peritonitis. Among the 17 cases, 7 cases were treated with glucocorticoid or immunosuppressant, 2 cases died, the remaining 15 cases were treated with compound sulfamine, minocycline, amikacin, meropenem. After the third generation of cephalosporal treatment, the condition was improved and discharged. 9 cases were followed up. Among them, 5 cases were treated with or without minocycline compound tablets for 6 months to 15 months, 4 cases were repeated, 3 cases were complicated with bronchiectasis and 2 cases lost their visits. Conclusion Nocardial bacillus can cause infection in all parts of the body, and the lung is the most common infection. People with underlying diseases are prone to Nocardial infections, especially with glucocorticoids and immunosuppressants. Nocariasis has no specific clinical manifestations. The first-line drugs are sulfanilamide, aminoglycosides and third generation cephalosporins. The prognosis of nocariasis infection site, whether the underlying disease, timely treatment and other factors related to.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R519.1

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