老年肺结核并发其他病原菌感染的病原菌分布及耐药性分析

发布时间：2019-01-04 23:19

【摘要】：目的探讨老年肺结核患者并发其他病原菌感染时病原菌分布情况及耐药性。方法选取2008年1月至2013年1月在该院治疗的老年肺结核并发其他病原菌感染患者83例,送痰培养及药敏试验,分析病原菌的分布情况及耐药情况。结果 83例患者共送检痰标本225次,培养出病原菌161株,其中细菌124株,真菌37株;G+菌51株对氨苄西林、阿奇霉素及青霉素G的耐药率高,对替考拉宁、亚胺培南、万古霉素的敏感性较高;G-菌73株对头孢噻肟、环丙沙星、氨曲南等耐药性高,对氨苄西林、头孢唑林、美洛培南、亚胺培南等敏感性高;真菌37株包括白假丝酵母菌21株,霉菌16株,对酮康唑、氟康唑、伊曲康唑、伏立康唑有不同程度的耐药性,对两性霉素的敏感性为100%。结论 G-杆菌是老年肺结核患者并发其他病原菌感染时的主要病原菌,G+菌和G-菌均对常用抗生素的耐药性较高,且真菌感染的比例较大,临床应根据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 and drug resistance of other pathogens in elderly patients with pulmonary tuberculosis. Methods from January 2008 to January 2013, 83 cases of senile pulmonary tuberculosis complicated with other pathogens infection were selected, sputum culture and drug sensitivity test were used to analyze the distribution and drug resistance of the pathogens. Results there were 225 sputum samples from 83 patients, 161 strains of pathogenic bacteria were cultured, including 124 strains of bacteria and 37 strains of fungi. 51 strains of G were resistant to ampicillin, azithromycin and penicillin G, and were sensitive to teicoplanin, imipenem and vancomycin. 73 strains of G- bacteria were highly resistant to cefotaxime, ciprofloxacin and aztreonam, and highly sensitive to ampicillin, cefazolin, meropenem and imipenem. 37 strains of fungi, including 21 strains of Candida albicans and 16 strains of fungi, had different drug resistance to ketoconazole, fluconazole, itraconazole and voriconazole, and the sensitivity to amphotericin was 100. Conclusion G- bacillus is the main pathogen in the elderly patients with pulmonary tuberculosis complicated with other pathogens. Both G and G- bacteria have high resistance to common antibiotics, and the proportion of fungal infection is larger. Rational antimicrobial agents should be selected according to the results of drug sensitivity test in order to enhance the curative effect and reduce the rate of drug resistance.
【作者单位】：广州医科大学附属第三医院呼吸内科;
【分类号】：R521;R446.5

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