肺结核并发下呼吸道感染患者的病原菌特点及危险因素分析

发布时间：2018-04-14 04:30

本文选题：肺结核 + 下呼吸道感染　；参考：《中华医院感染学杂志》2014年04期

【摘要】：目的探究肺结核并发下呼吸道感染患者的病原菌特点及危险因素,为临床医师预防治疗该病提供指导依据。方法选取感染科于2010年7月-2012年12月收治的26例肺结核并发下呼吸道感染患者,设为研究组;选取同期收治的28例肺结核无下呼吸道感染患者,设为对照组,对研究组患者行痰培养,了解主要病原菌类型,并采取单因素分析比较两组患者在年龄、病程、病灶范围、合并症、抗菌药物使用、住院时间、免疫功能的差异性,采取SPSS19.0软件进行统计分析。结果研究组患者经痰培养共检出病原菌43株,其中革兰阴性菌24株占55.8%,革兰阳性菌12株占27.9%,真菌7株占16.3%;研究组年龄60岁、病程3年、病灶占6肺野、存在并发症、使用抗菌药应用时间4周及住院时间60d的患者分别占65.4%、53.8%、61.5%、53.8%、80.8%、69.2%,均高于对照组的28.6%、17.9%、35.7%、25.0%、25.0%、25.0%,差异有统计学意义(P0.05);结核菌素试验阴性率研究组61.5%,对照组34.6%,结核抗体阴性率研究组为28.6%,对照组50.0%,两组差异均有统计学意义(P0.05)。结论革兰阴性菌是肺结核并发下呼吸感染的主要病原菌;高龄、结核病程过长、合并基础疾病数较多、抗菌药物不合理应用、住院时间及免疫功能受损是并发下呼吸道感染的危险因素。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics and risk factors of pulmonary tuberculosis complicated with lower respiratory tract infection, and to provide guidance for clinicians to prevent and treat the disease.Methods from July 2010 to December 2012, 26 patients with pulmonary tuberculosis complicated with lower respiratory tract infection were selected as study group, and 28 patients with pulmonary tuberculosis without lower respiratory tract infection were selected as control group.Sputum culture was performed on the patients in the study group to understand the main pathogenic bacteria types. Univariate analysis was used to compare the differences of age, course of disease, focus range, complications, antibiotic use, hospitalization time and immune function between the two groups.SPSS19.0 software was used for statistical analysis.Results A total of 43 strains of pathogenic bacteria were detected by sputum culture in the study group, of which 24 strains were Gram-negative bacteria (55.8%), 12 strains were Gram-positive bacteria (27.9B), and 7 strains were fungi (16.3%), the study group was 60 years old, the course of disease was 3 years, the lesion occupied 6 lung fields, and there were complications in the study group.The number of patients who used antimicrobial drugs for 4 weeks and 60 days in hospital accounted for 65.4and 53.8and 53.8respectively, which were higher than those in the control group (28.66.17.9) and 25.725.0 (25.0), the difference was significant (P0.05); the negative rate of tuberculin test was 61.5% in the study group, 34.6T in the control group, 28.662% in the TB antibody negative rate group, and 28.662% in the control group.In the control group, there was significant difference between the two groups (P 0.05).Conclusion Gram-negative bacteria are the main pathogens of pulmonary tuberculosis complicated with respiratory infection.Length of stay and impaired immune function were risk factors of lower respiratory tract infection.
【作者单位】：奉化市人民医院感染科;
【基金】：浙江省医药卫生科技计划基金资助项目(2012KYB191)
【分类号】：R521

【参考文献】