自身免疫病患者革兰阴性菌感染的病原菌分布及耐药性

Study on distribution of pathogens and their antibiotic resistance in autoimmune disease patients with gram-negative bacterial infections

目的了解自身免疫病(AD)患者革兰阴性菌感染病原菌的种类、分布及耐药状况,为临床合理使用抗生素提供依据。方法应用ATB Expression自动细菌鉴定系统对病原菌进行鉴定,用K—B法进行药敏试验。结果428例AD患者并发细菌感染186例,感染率为43.5%。共分离山病原菌285株,其中革兰阴性杆菌148株,占51.9%,主要为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌。大肠埃希菌和肺炎克雷伯菌中产超广谱β内酰胺酶(ESBLs)株检出率分别为29%和30.8%。药敏结果显示:革兰阴性杆菌对亚胺培南、美洛培南及头孢哌酮/舒巴坦耐药率最低。结论AD患者并发细菌感染的临床表现无特异性,本组资料对AD细菌感染的治疗和抗菌药物的选用具有重要参考价值。

Objective To study the distribution of pathogens and their antibiotic resistance in autoimmune disease(AD) patients with gram-negative bacterial infections,for guiding the rational use of antibiotics therapy.Methods The identification were analyzed by ATB Expressionautomatic microbiology analytical instrument system.The bacterial susceptibility test was done by Kirby-Bauer agar diffusion method.Reaults Of 428 patients studiad,186(43.5%) had bacterial infections.A total of 285 strains of pathogens had been isolated,among which 148 strains(51.9%) were gram-negative bacilli,the most common pathogens were Escherichia coli,Pseudomonas aeraginosa,Klebsiella pneumoniae.The ESBLs producing rates in Eschericbia coli and Klebsiella pneumomae were 29% and 30.8%.Resistance Rates of gram-negative bacilli to imlpenem,meropenem and cefoperazone/sulbactam were the lowest.Conclusion The clinical features of AD patients with bacterial infections are lack of specificity The data will be useful for reasonably choosing antimicrobial agents in the treatment of AD patients with bacterial infections.