肺结核患者合并社区获得性肺炎的病原菌分布与耐药菌分析

Distribution of pathogenic bacteria and drug resistance bacteria in patients with pulmonary tuberculosis combined with community-acquired pneumonia

目的分析肺结核合并社区获得性肺炎患者菌群分布特点及耐药风险因素分析。方法选取2017年4月-2018年4月在本院确诊为社区获得性肺炎的结核杆菌感染的患者60例为研究对象作为观察组,并以同期非结核的社区性获得性肺炎患者60例作为对照组,所有患者均进行病原学诊断,探讨肺结核合并社区获得性肺炎患者菌群分布特点并进行耐药分析,分析肺结核患者耐药菌感染的风险因素。结果观察组革兰阴性菌的发病率明显高于对照组;观察组对头孢曲松、氨曲南、莫西沙星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、万古霉素、头孢噻肟的耐药率均明显高于对照组;肺结核病程、肺功能、抗生素使用史是肺结核患者社区获得性肺炎耐药菌感染的独立危险因素(P<0.05)。结论肺结核病程、肺功能、抗生素使用史是患者耐药感染的独立风险因素,积极分析患者耐药菌感染的临床因素,有助于患者恢复病情。

Objective To analyze the bacterial distribution and drug resistance risk factors of pulmonary tuberculosis patients with community acquired pneumonia. Methods 60 patients with community acquired pneumonia diagnosed in our hospital from April 2017 to April 2018 were selected as the observation group, and 60 patients with non-tuberculosis community acquired pneumonia were selected as the control group. All the patients were etiologically diagnosed to explore the community acquired tuberculosis patients. Distribution characteristics of bacteria in patients with acquired pneumonia and drug resistance analysis were carried out to analyze the risk factors of drug-resistant bacteria infection in patients with pulmonary tuberculosis. Results The incidence rate of Gram-negative bacteria in the observation group was higher than that in the control group. The resistance rates of ceftriaxone, aztreonam, moxifloxacin, Cefoperazone/sulbactam, piperacillin/tazobactam, vancomycin and cefotaxime in the observation group were significantly higher than those in the control group. Course of pulmonary tuberculosis, pulmonary function, antibiotic use history were independent risk factors of community acquired pneumonia drug-resistant bacteria infection in pulmonary tuberculosis patients. Conclusion The course of tuberculosis, pulmonary function and antibiotic use history are independent risk factors for drug-resistant infection.