肺结核继发肺部感染的病原体种类及药敏分析  

Pathogen category and drug sensitivity analysis in pulmonary tuberculosis patients with secondary pulmonary infection

作　　者：张瑞霞[1] 娄婷叶[1] 杨义明[2] 

机构地区：[1]河南省新乡医学院附属第一医院检验科,卫辉453100 [2]重庆医科大学检验系,400016

出　　处：《国际检验医学杂志》2007年第10期894-896,共3页International Journal of Laboratory Medicine

摘　　要：目的研究肺结核患者继发肺部感染时的常见病原体种类及对其敏感的药物，为临床治疗提供参照与依据。方法对我院结核病区2003年1月～2005年12月肺结核患者疑有继发肺部感染时分离培养阳性的痰标本，进行病原体种类及药敏试验的综合分析。结果共分离出120株病原体，其中G^-杆菌52株，占43．3％；G^＋球菌32株，占26．7％；真菌33株，占27．5％；G^＋杆菌3株，占2．5％。感染率最高的病原菌是铜绿假单胞菌（23．3％）和白色念珠菌（21．7％）。药敏结果显示，所选的药物中，对G^-杆菌敏感性较高的药物有亚胺硫霉素（73．1％）、丁胺卡那霉素（53．9％）、环丙沙星（53．9％）、氧哌嗪青霉素／Tazobac（50．0％）、妥布霉素（50．0％）。对G^＋菌敏感性较高的药物有万古霉素（77．8％）、红霉素（33．3％）、庆大霉素（33．3％）、四环素（33．3％）、克拉霉素（33．3％）、利福平（33．3％）。结论铜绿假单胞菌、白色念珠菌是我院肺结核患者继发肺部感染时的最常见病原体，且细菌耐药严重。Objective To study pathogen category and sensitive drugs in pulmonary tuberculosis patients with secondary pulmonary infection, and so as to provide reference for clinical therapy. Methods The pathogen category and drug sensitivity were analyzed in positive sputum samples from the pulmonary tuberculosis patients with secondary pulmonary infection from Jan 2003 to Dec 2005 in our hospital. Results 120 strains of pathogens were isolated, of which G bacillus accounted for 52 strains （43.3%）,G^＋ coccobacteria 32 strains （26.7%）, mycetes 33 strains （27. 5%）, and G^＋ baceillus 3 strains （2.5 % ）. The highest infectious pathogen was Pseudomonas aeruginosa （23.3 % ） and Oidium albicans （21.7 %）. Drug sensitivity test displayed as follows： the sensitive drugs for G bacillus in sequence wasimipenem （73. 1%）, amikacin （53.9%）, ciprofloxacin （53.9%）, piperacillin （50.0%） and tenebrimycin （50.0%） respectively; the sensitive drugs for G^＋ bacterium in order was vancocin （77.8%）,erycin （33. 3%） and gentamicin （33. 3%o） and ambramycin （33. 3%）, clarithromycin （33.3 % ） and rifampicin （33.3 % ） respectively. Conclusion Pseudomonas aeruginosa and Oidium albicans are the most common pathogens in pulmonary tuberculosis patients with secondary pulmonary infection in our hospital, and they have a high drug resistance. Thus, sputum culture should be strengthened so as to identify the pathogen, select sensitive drugs and decrease drug resistant strains in pulmonary tuberculosis patients with secondary pulmonary infection.

关 键 词：肺结核 肺部感染 病原体 药物敏感 

分 类 号：R521.06[医药卫生—内科学] R563[医药卫生—临床医学]