耐多药肺结核患者呼吸道感染的病原菌耐药性分析

发布时间：2018-08-30 19:38

【摘要】：目的了解耐多药肺结核患者呼吸道感染的病原菌分布及耐药性,为正确选择抗菌药物治疗提供依据。方法选取2007年1月-2013年1月治疗的耐多药肺结核患者87例,采集患者痰标本进行培养及药敏试验,分析病原菌种类及耐药性,数据采用SPSS13.0软件进行统计分析。结果 87例患者痰标本培养出病原菌178株,其中革兰阴性菌124株占69.66%,革兰阳性球菌12株占6.74%,真菌42株占23.60%;金黄色葡萄球菌对氨苄西林、阿奇霉素及青霉素G的耐药率分别为100.00%、85.71%及100.00%;肺炎克雷伯菌对头孢噻肟、氨曲南、环丙沙星的耐药率分别为97.37%、94.94%、97.37%;真菌对酮康唑、氟康唑、伊曲康唑、伏立康唑有不同程度的耐药性,对两性霉素B的耐药率为0。结论革兰阴性杆菌是耐多药肺结核患者呼吸道感染的主要病原菌,真菌感染的比例较大,革兰阳性菌和革兰阴性菌均对常用的抗菌药物的耐药性较高,临床应根据细菌培养及药敏试验结果选用合理的抗菌药物,以增强疗效及降低耐药率。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug resistance of respiratory tract infection in multidrug resistant pulmonary tuberculosis (MDR-TB) patients, and to provide evidence for the correct selection of antimicrobial therapy. Methods from January 2007 to January 2013, 87 cases of multi-drug resistant pulmonary tuberculosis were selected. The sputum samples of the patients were collected for culture and drug sensitivity test, and the types of pathogens and drug resistance were analyzed. The data were statistically analyzed by SPSS13.0 software. Results 178 strains of pathogenic bacteria were cultured in sputum of 87 patients, of which 124 strains were Gram-negative bacteria (69.66%), 12 strains were Gram-positive cocci (6.74), and 42 strains were fungi (23.60%). The resistance rates of azithromycin to cefotaxime, aztreonam and ciprofloxacin were 97.3737 and 97.377.The resistance rates of the fungi to ketoconazole, fluconazole, itraconazole and voriconazole were 97.377.37, respectively, and the resistance rates of Klebsiella pneumoniae to cefotaxime, aztreonam and ciprofloxacin were 97.377.37, respectively. The resistance rate to amphotericin B was 0. Conclusion Gram-negative bacilli are the main pathogens of respiratory tract infection in patients with multi-drug resistant pulmonary tuberculosis, and the proportion of fungal infection is higher. Both Gram-positive and Gram-negative bacteria have higher resistance to common antimicrobial agents. Rational antimicrobial agents should be selected according to the results of bacterial culture and drug sensitivity test in order to enhance the curative effect and reduce the drug resistance rate.
【作者单位】：新乡医学院第一附属医院结核内科;新乡医学院第一附属医院神经外科;
【基金】：河南省科技攻关基金资助项目(HNK0897)
【分类号】：R521

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