摘要
目的探讨2016-2018年肺结核合并呼吸道感染患者病原菌分布及药敏变化趋势分析。方法对2016年至2018年确诊为肺结核患者的深部痰或支气管灌洗液标本进行细菌分离培养,分离致病菌菌株,用全自动细菌鉴定及药敏分析系统对病原菌进行细菌鉴定及药敏试验,并分析其耐药性变化趋势。结果4906例痰或支气管灌洗液标本中分离出致病性病原菌1005株,其中革兰阴性杆菌895株(89.05%),阳性球菌28株(2.79%),真菌82株(8.16%)。主要革兰阴性杆菌对多种碳青霉烯类、喹诺酮类、氨基糖甙类药物仍保持较高的敏感性,金黄色葡萄球菌对环丙沙星、苯唑西林、克林霉素、红霉素和青霉素有较高耐药性。铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌和大肠埃希菌对多种常用抗菌药物的耐药性呈逐年升高趋势。结论对于合并下呼吸道感染的肺结核患者,应根据药敏试验结果制订合理的治疗方案,并加强医院感染的防控管理。
Objective To investigate the distribution of pathogenic bacteria and the trend of drug sensitivity in patients with pulmonary tuberculosis complicated with respiratory infection from 2016 to 2018.Methods Bacterial isolation and culture were performed on deep sputum or bronchial lavage fluid samples from patients diagnosed with tuberculosis from 2016 to 2018.Bacterial identification and drug sensitivity tests were performed on pathogenic bacteria using a fully automatic bacteria identification and drug sensitivity analysis system,and trend of drug sensitivity was detected and analyzed.Results In 4,906 cases of sputum or bronchial lavage fluid samples,1005 pathogenic pathogenic bacteria were isolated,including 895 Gram-negative bacilli(89.05%),28 Gram-positive cocci(2.79%),and 82 fungi(8.16%).Major gram-negative bacilli remain highly sensitive to a variety of carbapenems,quinolones,and aminoglycosides.Staphylococcus aureus is highly resistant to ciprofloxacin,oxacillin,clindamycin,erythromycin and penicillin.The resistance of P.aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,and Escherichia coli to a variety of commonly used antibiotics has been increasing year by year.Conclusion For patients with pulmonary tuberculosis with lower respiratory tract infection,a reasonable treatment plan should be formulated based on the results of drug sensitivity tests,and the management of nosocomial infections should be strengthened.
作者
林炳耀
王勇萍
崔小颖
王威
曾今诚
林东子
LIN Bingyao;WANG Yongping;CUI Xiaoying;无(FoShan Fourth People’s Hospital,Foshan Guangdong,528000,China;Dongguan Key Laboratory of Medical Bioactive Molecular Developmental and Translational Research,Guangdong Medical University,Dongguan 523808,China)
出处
《江西医药》
CAS
2020年第8期967-970,共4页
Jiangxi Medical Journal
基金
国家自然科学基金青年基金项目,编号81500007
广东省医学科研基金项目,编号B2018014
东莞市社会科技发展项目,编号201750715005451,2018507150051657
佛山市自筹经费类科技计划项目(医学类科技攻关),编号1920001000648
佛山市卫生健康局医学科研课题,编号20200224
佛山市卫生健康局医学科研课题,编号20180138。
关键词
肺结核
呼吸道感染
病原菌
药物敏感性
趋势
Tuberculosis
Respiratory infection
Pathogen
Drug sensitivity
Trend
