摘要
目的研究煤矿工作者尘肺合并下呼吸道感染患者病原菌分布及耐药情况,为临床科学选用抗菌药物提供参考依据。方法采用病原菌分离鉴定技术和药敏试验方法,对某医院住院煤工尘肺者合并呼吸道感染病原菌进行检测与分析。结果共检测住院煤工尘肺患者送检标本1 300份,检出病原菌638株,检出率为49.08%。检出的病原菌中,革兰阴性杆菌占60.0%,革兰阳性球菌占6.58%,真菌占33.39%。排列前5位的优势菌依次为肺炎克雷伯菌、念珠菌、白假丝酵母菌、铜绿假单胞菌和产酸克雷伯菌。革兰阴性杆菌对青霉素类、头孢类、磺胺类和呋喃类抗菌药物耐药较严重,仅对碳青霉烯类和氨基糖甙类敏感。革兰阳性球菌普遍耐药,但未发现耐万古霉素菌株。结论革兰阴性杆菌为本地区煤工尘肺合并下呼吸道感染的主要病原菌,其常用抗菌药物耐药现状严重,临床医师应根据细菌耐药性变化趋势,合理选择应用抗菌药物。
Objective To study the distribution of pathogens isolated from lower respiratory infections in coalworker pneumoconiosis patients and drug resistance,so as to provide an effective basis for clinical antibiotics selection. Methods Bacterial separation and identification technology and drug sensitive test were used to detect and analysis pathogens isolated from lower respiratory tract in coalworker pneumoconiosis patients complicated with infection. Results Of 1 300 submitted specimens,there were 638 pathogens detected and the detection rate was 49. 08%. Of them,60. 0% were gram- negative bacilli,6. 58% were gram- positive bacilli,33. 39% were fungi. The top five were Klebsiella pneumonia,monilia,C. albicans,Pseudomonas aeruginosa and Klebsiella oxytoca. Gram- negative bacteria were highly resistant to Penicillin,Cephalosporin,sulfonamides and furans,and only susceptible to Penicillium carbon alkene and amino sugar glycosides. Gram-positive cocci were generally resistance to main antibacterial agents,only not found to Vancomycin. Conclusion Gram-negative bacteria are the main pathogens isolated from coal miner pneumoconiosis complicated with infection of the lower respiratory tract in the region,antimicrobial resistance to ordinary antibiotics is severe. Clinicians should be reasonable select antibiotics according to bacterial resistance trends.
出处
《中国消毒学杂志》
CAS
北大核心
2016年第3期230-232,共3页
Chinese Journal of Disinfection
基金
宁夏自然科学基金资助项目(NZ14266)
关键词
尘肺
下呼吸道感染
病原菌
耐药性
coalworker pneumoconiosis
lower respiratory tract infection
pathogenic bacteria
drug resistance
