肺结核继发感染铜绿假单胞菌耐药与年龄、性别及外周血CD4^(+)T淋巴细胞含量的关系研究  

Study on the Relationship of the Drug Resistance of Secondary Pseudomonas Aeruginosa Infection in Tuberculosis with Age,Sex or Number of of CD4^(+)T Lymphocyte in Peripheral Blood of Patients

作　　者：奚少勇 磨立达 罗晓璐[1] XI Shaoyong;MO Lida;LUO Xiaolu(Nanning Fourth People’s Hospital,Nanning 530023,China)

机构地区：[1]南宁市第四人民医院,广西医科大学南宁市传染病医院,广西艾滋病临床治疗中心(南宁),广西南宁530023

出　　处：《中国医学创新》2021年第25期162-166,共5页Medical Innovation of China

基　　金：南宁市科学研究与技术开发计划项目(20193008-2)。

摘　　要：目的:研究肺结核患者继发肺部感染铜绿假单胞菌的耐药性,从而指导临床用药。方法:收集南宁市第四人民医院2014年6月-2019年6月住院或门诊治疗的135例肺结核病例,采用半自动结核鉴定药敏系统和自动微生物鉴定仪,对135例痰液或灌洗液培养出结核分枝杆菌和铜绿假单胞菌肺结核患者进行铜绿假单胞菌药敏试验,分析不同患者的耐药性。结果:CD4^(+)T淋巴细胞<500个/μL者与≥500个/μL者对阿米卡星、环丙沙星、庆大霉素、头孢他啶、头孢吡肟、妥布霉素、哌拉西林、哌拉西林/他唑巴坦的耐药率比较,差异均无统计学意义(P>0.05);CD4^(+)T淋巴细胞<500个/μL者与≥500个/μL者对氨曲南、美罗培南、左氧氟沙星的耐药率比较,差异均有统计学意义(P<0.05)。不同年龄和性别的患者对阿米卡星、氨曲南、环丙沙星、美罗培南、庆大霉素、头孢他啶、头孢吡肟、妥布霉素、左氧氟沙星、哌拉西林和哌拉西林/他唑巴坦的耐药率比较,差异均无统计学意义(P>0.05)。结论:肺结核患者继发肺部感染铜绿假单胞菌时,外周血CD4^(+)T淋巴细胞<500个/μL的患者对氨曲南、美罗培南和左氧氟沙星的耐药率更高,临床用药应高度重视。Objective:To study the drug resistance of pseudomonas aeruginosa secondary to pulmonary infection in patients with pulmonary tuberculosis,so as to guide clinical medication.Method:A total of 135 cases of tuberculosis treated in the Fourth People’s Hospital of Nanning from June 2014 to June 2019 were collected.The drug susceptibility test of pseudomonas aeruginosa in 135 tuberculosis patients with Mycobacterium tuberculosis and pseudomonas aeruginosa cultured in sputum or perfusion fluid was carried out by using semi-automatic tuberculosis drug susceptibility system and automatic microorganism identification instrument.The drug resistance of different patients was analyzed.Result:Comparison of the drug resistance rates of CD4^(+)T lymphocytes < 500 /μL and ≥500 /μLto Amikacin,Ciprofloxacin,Gentamicin,Ceftazidime,Cefepime,Tobramycin,Piperacillin and Piperacillin/Tazobactam,there were no significant differences (P>0.05).The drug resistance rates of CD4^(+)T lymphocytes < 500 /μLand ≥500 /μL to Aztreonam,Meropenem and Levofloxacin were compared,the differences were statistically significant (P<0.05).Comparison of drug resistance rates of Amikacin,Aztreonam,Ciprofloxacin,Meropenem,Gentamicin,Ceftazidime,Cefepime,Tobramycin,Levofloxacin,Piperacillin and Piperacillin/Tazobactam in patients of different ages and genders,there were no significant differences (P>0.05).Conclusion:In pulmonary tuberculosis patients with secondary pulmonary infection of pseudomonas aeruginosa,patients with peripheral blood CD4^(+)T lymphocytes <500/μL had higher drug resistance rates to Amtronam,Meropenem and Levofloxacin,which should be paid more attention to in clinical use.

关 键 词：肺结核 肺部感染 铜绿假单胞菌 CD4+T淋巴细胞 耐药率 

分 类 号：R521[医药卫生—内科学]