铜绿假单胞菌致糖尿病并肺结核患者肺部感染的耐药特征分析  

The drug resistance of lung infections in patients with diabetes mellitus and pulmonary tuberculosis caused by Pseudomonas aeruginosa

作　　者：徐浩[1] 陆晓东[1] 冯胜春[1] 

机构地区：[1]金华市中心医院检验科,浙江金华321000

出　　处：《中国微生态学杂志》2014年第12期1431-1433,1440,共4页Chinese Journal of Microecology

摘　　要：目的探讨糖尿病并肺结核患者铜绿假单胞菌肺部感染的临床特征及对常用抗菌药物的耐药特点,为临床医师预防与治疗提供依据。方法调查2009年7月至2014年6月174例糖尿病并肺结核患者发生铜绿假单胞菌肺部感染临床资料,无菌操作采集痰液标本进行细菌培养和菌种鉴定;药敏试验采用K-B法操作,实验数据采用软件WHONET 5.6进行统计分析。结果 174株铜绿假单胞菌对阿米卡星、妥布霉素、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦等抗菌药物的耐药率〈20.0%,可作为本院治疗铜绿假单胞菌感染的经验用药;对米诺环素、复方新诺明的耐药率〉75.0%;对其他抗菌药物耐药率均在20.0%~75.0%。结论从糖尿病并肺结核患者痰液中分离出的铜绿假单胞菌的耐药率比较高,对多种抗菌药物均产生不同程度的耐药,临床应加强其耐药性监测及针对性管理措施,减少耐药性菌株产生。Objective To analyze the clinical features of pulmonary Pseudomonas aeruginosa infection in patients with diabetes and the drug resistance to commonly used antimicrobial agents, and provide physicians with the basis for prevention and treatment. Methods The clinical data of 174 cases of diabetes complicated with pulmonary tuberculosis and pulmonary Pseudomonas aeruginosa infection from July 2009 to June 2014 were analyzed. Sputum specimens were aseptically collected for bacterial culture and strain identification; susceptibility test was performed by using K-B method, and the resulting data were analyzed by using WHONETS. 6 software. Results The resistance rates of the 174 Pseudomonas aerugirtosa to Amikacin, Tobramycin, Cefoperazone/Sulbactam, Piperacillin/ Tazobactam and other antimicrobial drugs were lower than 20. 0% , while the resistance rates to Minocycline and Sulfamethoxazole were over 75% ; the resistance rate to other antimicrobial drugs were between 20. 0% and 75.0%. Conclusion The Pseudomonas aeruginosa isolated from the sputum of patients with diabetes mellitus and pulmonary tuberculosis are highly resistant to a variety of antimicrobial agents, which should be monitored closely to prevent the occurrence of its drug resistance.

关 键 词：铜绿假单胞菌 糖尿病并肺结核 肺部感染 耐药性 

分 类 号：R378.991[医药卫生—病原生物学]