新型冠状病毒感染合并细菌感染患者痰标本分离菌菌种分布及药物敏感性分析  

Strain distribution and drug sensitivity in sputum samples of patients with COVID-19 compli-cated with bacterial infection

作　　者：杨军 张勇进 赵燕 李利 杨凯 Yang Jun;Zhang Yongjin;Zhao Yan;Li Li;Yang Kai(Department of Neurosurgery,First People′s Hospital of Jinzhong,Jinzhong,Shanxi 030600,China;Department of Intensive Care Medicine,First People′s Hospital of Jinzhong,Jinzhong,Shanxi 030600,China;Clinical Labora-tory,First People′s Hospital of Jinzhong,Jinzhong,Shanxi 030600,China;Department of Respiratory Medicine,First People′s Hospital of Jinzhong,Jinzhong,Shanxi 030600,China)

机构地区：[1]晋中市第一人民医院神经外科,山西晋中030600 [2]晋中市第一人民医院重症医学科,山西晋中030600 [3]晋中市第一人民医院检验科,山西晋中030600 [4]晋中市第一人民医院呼吸科,山西晋中030600

出　　处：《中国药物与临床》2024年第13期842-846,共5页Chinese Remedies & Clinics

基　　金：山西省卫生健康委员会科研课题(2023XG089)。

摘　　要：目的分析新型冠状病毒感染合并细菌感染患者的痰标本中分离到的致病菌的菌种分布特点及其对抗菌药物的敏感性。方法收集晋中市第一人民医院2022年12月至2023年2月住院治疗的新型冠状病毒感染患者的相关资料,分析这些患者痰标本中致病菌的种类及分布,以及对各种抗菌药物的敏感性。结果共收集到诊断为新型冠状病毒感染的患者1056例,其中痰标本细菌培养阳性的患者105例(9.94%)。共分离到127株致病菌,肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌分别为53株(41.73%)、30株(23.62%)、17株(13.39%)、11株(8.66%)、9株(7.09%)。肺炎克雷伯菌、大肠埃希菌和铜绿假单胞菌对阿米卡星、头孢他啶、头孢哌酮舒巴坦等均有较高的敏感性(>80%)。鲍曼不动杆菌对哌拉西林他唑巴坦的敏感率最高(50%)。金黄色葡萄球菌对喹诺酮类及万古霉素、利奈唑胺等的敏感率较高(>80%)。结论部分新型冠状病毒感染患者可能同时合并细菌性肺炎,需要积极鉴定致病菌并合理选择敏感抗生素。Objective To analyze the distribution of bacterial strains isolated from sputum samples of patients with COVID-19 complicated with bacterial infection,and their antibiotic susceptibility patternss.Methods This study collected relevant data of hospitalized patients diagnosed with COVID-19 pneumonia at our hospital between December 2022 and February 2023.The distribution of pathogenic bacteria in the sputum samples of these patients and their susceptibility to antibiotics was analyzed.Results A total of 1056 patients diagnosed with COVID-19 infection were included,among which 105 cases(9.94%)had positive bacterial cultures in their sputum samples.A total of 127 pathogenic bacterial strains were isolated,with Klebsiella pneumoniae,Acinetobacter bau-mannii,Escherichia coli,Pseudomonas aeruginosa,and Staphylococcus aureus accounting for 41.73%(53 cases),23.62%(30 cases),13.39%(17 cases),8.66%(11 cases),and 7.09%(9 cases)respectively.Klebsiella pneumoni-ae,Escherichia coli,and Pseudomonas aeruginosa showed high sensitivity to amikacin,ceftazidime,and cefopera-zone-sulbactam(>80%).Acinetobacter baumannii demonstrated the highest sensitivity rate to piperacillin-tazobac-tam(50%).Staphylococcus aureus exhibited high sensitivity rates(>80%)to ciprofloxacin,moxifloxacin,lev-ofloxacin,nitrofurantoin,gentamicin,vancomycin,and linezolid.Conclusion Some patients infected with the novel coronavirus may concurrently develop bacterial pneumonia,necessitating active identifica tion of the causative pathogens and a rational selection of antibiotics sensitive to these pathogens.

关 键 词：新型冠状病毒感染 肺炎 细菌性 微生物敏感性试验 

分 类 号：R511[医药卫生—内科学] R446.5[医药卫生—临床医学]