呼吸道感染治疗后咽部菌群变化的研究  

Throat Bacteria Variation in Respiratory Tract Infection after Antibiotic Therapy

作　　者：张利侠[1] 党淑萍[1] 马娟[1] 杨淑梅[1] 

机构地区：[1]陕西省人民医院检验科,陕西西安710068

出　　处：《中华医院感染学杂志》2010年第6期815-817,共3页Chinese Journal of Nosocomiology

摘　　要：目的以健康人咽部菌群为研究基础,研究呼吸道感染经广谱抗菌药物治疗后咽部菌群的变化。方法采集2004年1月～2007年12月健康人、呼吸道感染未治疗及治疗后患者的咽拭子各180例进行需氧、二氧化碳培养及厌氧培养。结果呼吸道感染治疗前、后患者需氧菌密度与健康组差异有统计学意义(P<0.05),治疗后患者的厌氧菌密度与健康组差异有统计学意义(P<0.01);抗菌药物的治疗对呼吸道的菌群数量和种类有一定的影响,可诱导细菌耐药性升高,肺炎克雷伯菌产ESBLs由治疗前的43.5%上升到65.7%,鲍氏不动杆菌产AmpC酶由治疗前的28.6%上升到44.4%。结论呼吸道感染在广谱抗菌药物治疗后咽部菌群的种类和数量会失调,甚至会选择出引起呼吸道感染的高耐药条件致病菌,尤其是铜绿假单胞菌和鲍氏不动杆菌等。OBJECTIVE To study the variation and tendency of the throat bacteria in respiratory tract infection after antibiotic therapy and compare with healthy people.METHODS We made aerobic and anaerobic cultivation,carbon dioxide cultivation of 480 throat swab samples from Jan 2004 to Dec 2007,and at the same time,we analyzed the distribution of normal flora among healthy people for comparison.RESULTS The density of aerobacterls in non and with antibiotic therapy groups were significant lower than that in health group（P0.05）;especially Escherichia coli and Acinetobacter baumannii;The rate of Extended-spectrum bata-lactamases increased from 43.5% to 65.7% in E.coli and Ampler class C bata-lactamase from 28.6% to 44.4% in A.baumannii.CONCLUSIONS There are colonization density and abundance normal flora in respiratory tract,keeping stability and integrity in the host.If the balance condition of host have been demaged,which easily lead to respiratory infection,especially for senile patients.The high resistant pathogens can be chosen out especial Pseudomonas aeruginosa and A.baumannii.

关 键 词：呼吸道感染 咽部菌群 研究 

分 类 号：R181.32[医药卫生—流行病学]