摘要
目的 分析煤工尘肺（CWP）慢性阻塞性肺疾病（COPD）下呼吸道感染耐亚胺培南革兰阴性杆菌（IR-GNB）的耐药特性,为临床治疗提供依据.方法 对从煤工尘肺并发COPD下呼吸道感染患者痰液中分离的66株IR-GNB研究分布特征,采用K-B纸片扩散法研究菌株的耐药特性.结果 66株IR-GNB主要以铜绿假单胞菌（29株,占43.9％）;鲍曼不动杆菌（17株,占25.8％）;嗜麦芽寡养单胞菌（11株,占16,7％）等细菌为主.所有细菌的耐药性均较强,其中铜绿假单胞菌对环丙沙星、多黏菌素B、磷霉素、阿米卡星敏感率大于50％;鲍曼不动杆菌对磷霉素、多黏菌素B、头孢哌酮/舒巴坦敏感率大于55％;嗜麦芽寡养单胞菌对复方新诺明、环丙沙星、哌拉西林/他唑巴坦、左氧氟沙星、多黏菌素B、头孢哌酮/舒巴坦敏感率超过50％.结论 煤工尘肺COPD下呼吸道IR-GNB以铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽寡养单胞菌等非发酵细菌为主,细菌耐药性较强,仅对少数药物敏感.
Objective To investigate the drug resistance ofimipenem-resistant （IR） Gram-negative bacilli （GNB） in coal workers＇ pneumoconiosis （CWP）-chronic obstructive pulmonary disease （COPD） patients with lower respiratory tract infection （LRTI） and to provide a basis for clinical treatment.Methods Sixty-six strains of IR-GNB were isolated from the sputum of CWP-COPD patients with LRTI,and the bacterial spectrum was investigated.The drug resistance of bacterial strains was studied by KB disk diffusion method.Results Among the 66 strains of IR-GNB,29 （43.9％） were Pseudomonas aeruginosa,17 （25.8％） were Acinetobacter baumannii,and 11 （16.7％） were Stenotrophomonas maltophilia.The drug sensitivity test showed that all bacteria had high drug resistance; Pseudomonas aeruginosa had a susceptibility rate higher than 50％ to ciprofloxacin,polymyxin B,fosfomycin,and amikacin,Acinetobacter baumannii had a susceptibility rate higher than 55％ to fosfomycin,polymyxin B,and cefoperazone/sulbactam,Stenotrophomonas mahophilia had a susceptibility rate higher than 50％ to cotrimoxazole,ciprofloxacin,piperacillin/tazobactam,levofloxacin,polymyxin B,and cefoperazone/sulbactam,and Pseudomonas cepacia had a susceptibility rate higher than 50％ to piperacillin/tazobactam,ciprofloxacin,cefoperazone/sulbactam,and polymyxin B.Conclusion The main species of IR-GNB are such non-fermentative bacteria as Pseudomonas aeruginosa,Acinetobacter baumannii,and Stenotrophomonas maltophilia in CWP-COPD patients with LRTI.These bacteria have high drug resistance and are sensitivc to only a limited range of antibiotics.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2013年第9期700-702,共3页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
尘肺
肺疾病
阻塞性
亚胺培南
革兰阴性菌感染
Pneumoconiosis
Lung diseases, obstructive
Imipenem
Gram-negative bacterial infections
