肺结核继发嗜麦芽窄食单胞菌感染的临床及药敏分析  

Clinical characteristics and drug sensitivity tests of pulmonary tuberculosis complicated by Stenotrophomonas maltophilia infection

作　　者：林燕青[1] 邱卡仪[1] 陈梅英[1] 

机构地区：[1]福建省龙岩市第二医院,364000

出　　处：《山西医药杂志》2006年第4期294-296,共3页Shanxi Medical Journal

摘　　要：目的分析和总结肺结核继发嗜麦芽窄食单胞菌感染的临床特点及对抗生素的耐药情况。方法对23例肺结核继发嗜麦芽窄食单胞菌感染的临床资料进行统计分析,药敏试验采用扩散法,并按全国临床检验标准委员会(NCCLS)标准判断耐药性。结果合并嗜麦芽窄食单胞菌感染的肺结核主要特点:结核病史长,年龄偏大,以浸润型和慢性纤维空洞型肺结核为主,肺部病变广泛,病情严重,不合理使用广谱抗生素、化疗、激素使用及各种侵袭性操作为本病高危因素,确诊有赖于病原学检查。该菌对常用抗生素广泛耐药。结论肺结核继发嗜麦芽窄食单胞菌感染有增多趋势,多发生在肺结核病情严重、免疫功能低下者,各种高危因素又促成本病发生,该菌耐药严重,正确、合理治疗有赖于药敏结果。Objective To explore the clinical characteristics of pulmonary tuberculosis complicated by Stenotrophomonas maltophilia infection and the antibiotic sensitivity of St. maltophilia strains. Methods Retrospective study of the clinicsl data of 23 paients with pulmonary tuberculosis complicated by St. maltophilia infection. Diffusion tests were used to measttre the antibiotic sensitivity of St. maltophilia, and resistance was analysed according to NCCLS standard. Results The major clinical features of pulmonary tuberculosis complicated by St. maltophilia infection were as follows：long case history, usual occurrence in older patients and the patients with infiltrative pulmonary tuberculosis or chronic fibrocavitative pulmonary tuberculosis, extensive lesions in lungs. Irrational use of broad spectrum antibiotics, chemotherapy, corticostexoids and various invasive treatments were the risk factors. Their diagnosis depended on the examination of pathogenic microorganisms. The drug sensitivity tests in vitro showed that these strains were multiresistant to ecunmonly used antibiotics. Conclusion The number of patients with pulmonary tuberculosis complicated by St. maltophitia infection is increasing. The pulmonary tuberculosis complicated by St. maltophilia infection is developing in patients with extensive lesion in lungs and various risk factors. The correct and appropriate treatment depends on drug sensitivity.

关 键 词：肺结核 嗜麦芽窄食单胞菌 抗药性 微生物 

分 类 号：R521[医药卫生—内科学] R446.5[医药卫生—临床医学]