肺结核并重症肺炎行有创机械通气患者下呼吸道病原菌分布及耐药性特点

发布时间：2018-02-22 10:49

本文关键词： 肺结核重症肺炎机械通气病原菌药物敏感性　出处：《南方医科大学学报》2014年08期 　论文类型：期刊论文

【摘要】：目的探讨肺结核合并重症肺炎行有创机械通气行下呼吸道感染的病原菌分布及耐药性特点。方法对我院2006年1月~2013年1月收治的肺结核合并重症肺炎行有创机械通气的患者共208例进行统计分析,记录下呼吸道感染病原菌构成及药物敏感率。结果 208例样本成功分离出病株355株。细菌培养结果以革兰氏阴性菌为主(281株,占79.2%);其次为真菌(62株,17.5%)和革兰氏阳性菌(12株,占3.4%)。其中混合感染68例,占19.2%。对革兰氏阴性杆菌敏感率在60%以上的抗生素有美洛培南、亚胺培南和阿米卡星。替考拉宁、万古霉素、夫地西酸对革兰氏阳性菌敏感率为100%。结论革兰氏阴性菌、真菌和革兰氏阳性菌是肺结核合并重症肺炎行有创机械通气患者下呼吸道感染的最主要致病菌;亚胺培南、美洛培南、和阿米卡星是有效的治疗药物;我院肺结核合并重症肺炎行有创机械通气患者存在多重耐药性,应坚持病原菌培养和药敏试验,根据试验结果合理选用抗生素。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug resistance of pulmonary tuberculosis complicated with severe pneumonia by invasive mechanical ventilation and lower respiratory tract infection. Methods from January 2006 to January 2013, pulmonary tuberculosis with severe pneumonia were treated with invasive machinery. A total of 208 patients with ventilation were analyzed statistically. Results 355 strains were isolated successfully from 208 samples, 281 strains were Gram-negative bacteria (79.2%), 62 strains were fungi (17.5 strains) and 12 strains were Gram-positive bacteria. There were 68 cases of mixed infection, accounting for 19.2.The antibiotics sensitive to Gram-negative bacilli above 60% were meropenem, imipenem and amikacin, teicoplanin, vancomycin, teicoplanin, vancomycin, teicoplanin, vancomycin, imipenem and amikacin. Conclusion Gram-negative bacteria, fungi and gram-positive bacteria are the main pathogens of lower respiratory tract infection in patients with pulmonary tuberculosis and severe pneumonia. And amikacin is an effective treatment drug in our hospital, patients with pulmonary tuberculosis and severe pneumonia have multiple drug resistance, we should insist on pathogen culture and drug sensitivity test, and choose antibiotics reasonably according to the test results.
【作者单位】：广州市胸科医院重症结核科;
【基金】：广东省科技计划项目(2013-137-116)
【分类号】：R521

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