2013年-2015年住院肺结核患者下呼吸道革兰阴性菌分布及耐药性分析  

Distribution of pathogenic G-bacteria causing lower respiratory tract infections in the hospitalized tuberculosis patients and their drug resistance analysis from 2013 to 2015yr

作　　者：冯冉冉[1] 张丽霞[1] 刘刚[1] 杜岩青[1] 冯爽[1] 吴敏[1] 

机构地区：[1]天津市海河医院检验科,国家中医药管理局中医药防治传染病重点研究室,天津300350

出　　处：《实用医药杂志》2016年第12期1078-1080,1084,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨结核合并下呼吸道感染住院患者痰培养的革兰阴性菌构成特点和耐药情况变迁,为临床合理使用抗菌药物提供科学依据。方法对2013年—2015年住院结核患者送检的合格痰标本进行常规细菌分离培养,培养阳性结果用VITEK-2 Compact全自动微生物分析仪进行细菌鉴定及药敏试验。结果共分离出革兰阴性菌1229株,革兰阴性菌前5位依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌和鲍曼不动杆菌,其中前两者对大多数抗菌药物的耐药率均在50%以下,对革兰阴性菌敏感率高的抗生素是头孢吡肟、哌拉西林/他唑巴坦、氨基糖苷类、亚胺培南等。结论革兰阴性菌感染率以及耐药率的逐渐增高应当引起足够的警惕,加强临床病原菌及其耐药性的监测,对于临床合理使用抗菌药物,有效治疗结核患者下呼吸道感染以及减缓耐药菌株的产生具有重要意义。Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria causing lower respiratory tract infections in the hospitalized tuberculosis patients and provide scientific evidence for clinically reasonable use of antibiotics. Method Sputum specimens from the hospitalized tuberculosis patients in author’s hospital from 2013 to 2015 were collected for routine bacterial isolation and culture. The VITEK-2 Compact automated microbial analyzer was used for identifying the isolated strains and for susceptibility testing. Results A total of 1229 Gram bacill bacterial strains were isolated,and the top five were Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,enterobacter cloacae and Acinetobacter baumannii. The drug resistance rate of the first two to the majority antibiotics were below 50%. The drug sensitive rate of these strains to cefepime,Piperacillin Sodium/Tazobactam Sodium,imipenem and meropenem. Conclusion The infection rates which guadually increased in Gram-bacilli should be taken seriously enough. The monitoring of clinical pathogens and their resistance should be strengthened.It is of great significance to use antibiotics rationally,control the infection of lower respiratory tract in the tuberculosis patients effectively and to reduce the occurrence of resistant bacteria or retard their development.

关 键 词：结核患者 下呼吸道 病原菌 分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]