抗生素在尘肺病治疗中的不利因素

发布时间：2018-02-11 00:30

本文关键词： 抗生素尘肺病耐药性　出处：《职业与健康》2016年24期 　论文类型：期刊论文

【摘要】：目的探讨如何科学合理地使用抗生素治疗尘肺病以提高临床疗效。方法选取2014年1月—2016年1月间在开滦职业病防治院接受治疗357例尘肺病合并下肺部感染患者作为研究对象,采用病原菌分离鉴定技术和药敏试验方法,进行细菌鉴定和耐药试验,综合分析抗生素在尘肺病治疗中的不利因素。结果通过分离113株病原菌,阳性率为31.65%;其中革兰阴性杆菌占72.57%,革兰阳性球菌占18.58%,真菌占8.85%。耐药试验革兰阴性杆菌对第2及第3代头孢菌素类药物有较高的耐药性,其中铜绿假单胞菌的耐药性最高,对氨苄西林的耐药性高达92.31%;革兰阳性球菌对头孢菌素类药物的耐药性最高,其中金黄色葡萄球菌对克林霉素的耐药性、肺炎链球菌对氧氟沙星的耐药性均高达100%,对万古霉素的敏感性最高;白假丝酵母菌、白色念珠菌对酮康唑的耐药性达100%,此外患者肺组织病理变化及宿主防御机制的破坏也是抗生素治疗尘肺病的不利因素。结论在尘肺病临床治疗中要及时监测耐药趋势及病原菌变化,根据患者耐药情况及时调整抗生素的使用情况,同时加强对医护人员抗生素相关知识和使用方法的培训,减少不合理使用情况,提高尘肺病的治疗效果。
[Abstract]:Objective to explore how to use antibiotics scientifically and reasonably to treat pneumoconiosis in order to improve the clinical efficacy. Methods from January 2014 to January 2016, 357 cases of pneumoconiosis complicated with lower lung infection were treated in Kailuan Occupational Disease Prevention and treatment Hospital. Bacteria identification and drug resistance test were carried out by means of isolation and identification of pathogenic bacteria and drug sensitivity test. The adverse factors of antibiotics in the treatment of pneumoconiosis were comprehensively analyzed. Results 113 strains of pathogenic bacteria were isolated. The positive rate of Gram-negative bacilli was 72.57, Gram-positive cocci 18.58 and fungi 8.85.The drug resistance test showed that Gram-negative bacilli had high resistance to the second and third generation cephalosporins, among which Pseudomonas aeruginosa had the highest resistance. The resistance to ampicillin was 92.31%. Gram-positive cocci had the highest resistance to cephalosporins, among which Staphylococcus aureus was resistant to clindamycin. Streptococcus pneumoniae were resistant to ofloxacin as high as 100 and had the highest sensitivity to vancomycin. The resistance of Candida albicans to ketoconazole is 100. In addition, the pathological changes of lung tissue and the destruction of host defense mechanism are also the unfavorable factors for antibiotic treatment of pneumoconiosis. Conclusion the drug resistance should be monitored in time in clinical treatment of pneumoconiosis. Trends and changes of pathogenic bacteria, According to the situation of drug resistance of patients, the use of antibiotics should be adjusted in time. Meanwhile, the training on knowledge and methods of antibiotics should be strengthened to reduce the unreasonable use of antibiotics and to improve the therapeutic effect of pneumoconiosis.
【作者单位】：开滦职业病防治院药剂科;
【分类号】：R135.2

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