支气管扩张伴感染患者BALF病原菌检测及药敏结果分析  

Detection of BALF Pathogens and Analysis of Drug Susceptibility in Patients with Bronchiectasis and Infection

作　　者：李春喜 赵杰 赵立祥 朱晨 LI Chunxi;ZHAO Jie;ZHAO Lixiang;ZHU Chen(The Sixth People's Hospital of Fuyang City,Fuyang 236000,China;不详)

机构地区：[1]阜阳市第六人民医院,安徽阜阳236000

出　　处：《中外医学研究》2024年第36期1-5,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2021年阜阳市卫生健康委科研面上项目(FY2021-157)。

摘　　要：目的:分析支气管扩张(BE)伴感染患者支气管肺泡灌洗液(BALF)病原菌分布以及药敏结果。方法:选取2022年4月—2023年9月阜阳市第六人民医院收治的60例BE伴感染患者作为研究对象,对患者BALF标本进行病原菌检测以及药敏试验。结果:60例BE伴感染患者中,BALF培养阳性36例(60.00%)。共分离出58株细菌,其中革兰氏阳性菌6株(10.34%),包括金黄色葡萄球菌3株、肺炎链球菌2株以及溶血葡萄球菌1株;革兰氏阴性菌50株(86.21%),包括铜绿假单胞菌26株、肺炎克雷伯菌11株、鲍曼不动杆菌7株、大肠埃希菌4株以及嗜麦芽窄食单胞菌2株;真菌2株(3.45%)。革兰氏阳性菌中,金黄色葡萄球菌对阿奇霉素、克林霉素、红霉素、青霉素的耐药率分别为66.67%、66.67%、66.67%、100.00%。革兰氏阴性菌中,鲍曼不动杆菌普遍耐药程度最高,其中对米诺环素和阿米卡星最为敏感,分别为14.29%和28.57%,对头孢哌酮舒巴坦、哌拉西林他巴唑坦的耐药率分别为57.14%和71.43%;铜绿假单胞菌对头孢哌酮舒巴坦、哌拉西林他巴唑坦以及阿米卡星敏感性分别为19.23%、26.92%和15.38%;肺炎克雷伯菌对头孢哌酮舒巴坦、哌拉西林他巴唑坦以及阿米卡星敏感性分别为18.18%、18.18%和18.18%;大肠埃希菌对头孢哌酮舒巴坦、哌拉西林他巴唑坦以及阿米卡星敏感性分别为25.00%、25.00%和25.00%。结论:BE伴感染患者BALF病原菌主要以革兰氏阴性菌为主,各种病原菌对抗菌药物的敏感度存在较大的差异,加强病原菌耐药性监测有利于临床制定或调整患者的治疗方案。Objective:To analyze the pathogenic bacteria distribution and drug susceptibility of bronchoalveolar lavage fluid (BALF) in patients with bronchiectasis (BE) and infection.Method:From May 2020 to May 2022,60 cases of BE patients with infection were selected as the study objects from the Sixth People's Hospital of Fuyang City,and the pathogen detection and drug susceptibility test of BALF samples were performed.Result:Among 60 patients with BE infection,36 (60.00%) were positive for BALF culture.A total of 58 strains were isolated,of which 6 (10.34%) were Gram-positive,including 3 strains of Staphylococcus aureus,2 strains of Streptococcus pneumoniae and 1 strain of Staphylococcus hemolyticus.There were 50 Gram-negative bacteria strains (86.21%),including 26 strains of Pseudomonas aeruginosa,11 strains of Klebsiella pneumoniae,7 strains of Acinetobacter baumannii,4 strains of Escherichia coli and 2 strains of stenotrophomonas maltophilia,and 2 strains of fungi (3.45%).The resistance rates of Staphylococcus aureus to azithromycin,clindamycin,erythromycin and penicillin were 66.67%,66.67%,66.67% and 100.00%,respectively.Among gram-negative bacteria,Acinetobacter baumannii had the highest drug resistance,among which minocycline and amikacin were the most sensitive (14.29% and 28.57%,respectively),and cefoperazone and sulbactam,piperacillin and tabazotam were 57.14% and 71.43%,respectively.The sensitivity of Pseudomonas aeruginosa to cefoperazone sulbactam,piperacillin tabazotam and amicacin were 19.23%,26.92% and 15.38%,respectively.The sensitivity of Klebsiella pneumoniae to cefoperazone sulbactam,piperacillin tabazotam and amikacin were 18.18%,18.18% and 18.18%,respectively.The sensitivity of Escherichia coli to cefoperazone sulbactam,piperacillin tabazotam and amicacin were 25.00%,25.00% and 25.00%,respectively.Conclusion:The majority of BALF pathogens in BE patients with infection are Gram-negative bacteria,and there are great differences in the sensitivity of various pathogens to antibiotics.Strengthening the mo

关 键 词：支气管扩张 感染 支气管肺泡灌洗液 病原菌培养 药敏试验 

分 类 号：R44[医药卫生—诊断学]