156例肺结核患者合并下呼吸道感染致病菌种的临床分析

Clinical analysis of pathogenic bracteria strain in lower respiratory tract of 156 patients with tuberculosis

目的探讨肺结核患者下呼吸道致病菌种分布特点,细菌耐药情况。方法对滨州市结核病防治院2008年6月至2009年6月的156例肺结核住院患者的痰细菌培养发现致病菌的痰培养结果进行回顾性分析。结果 156例患者培养出186株致病菌,革兰氏阴性杆菌占61.3%,革兰氏阳性球菌占22.6%,真菌占16.1%。其中铜绿假单胞菌、肺炎克雷白杆菌、金黄色葡萄球菌、白色念珠菌为主要细菌。药敏试验提示多数致病菌对未加β-内酰胺酶抑制剂的青霉素及第一、二代、部分第三代头孢菌素耐药严重,对碳青酶烯类抗生素敏感率较高,万古霉素对金黄色葡萄球菌的敏感率为100%。结论肺结核合并下呼吸道感染及耐药情况严重,因此在肺结核患者合并感染临床选用抗生素治疗时应以药敏试验为依据。

Objective To investigate the characteristics of distribution and drug resistance of pathogenic bracteria strain in lower respiratory tract of patients with tuberculosis.Method The results of microbial culture of 156 patients with tuberculosis in Tuberculosis hospital in Bin Zhou from June 2008 to June 2009 were analysed retrospectively.Result 186 strains of pathogenic bacteria were cultured in 156 patients.Gram negative bacillus accounted for 61.5%.Gram negative pole coccus accounted for 22.6%.Fungi accounted for 16.1%.The main bacteria were Pseudomonas aeruginosa,Pneumonia,White clay,Staphylococcus aureus,and Candida albicans.Susceptibility test indicated that the majority of pathogenic bacteria were significant resistance to not beta-lactamase-producing eniyme inhibitors of penicillin and the first and second,some third-generation cephalosporin,but for carbon eniyme of antibiotic sensitivity rate was higher.Vancomycin for staphylococcus aureus sensitive rate was 100%.Conclusion Tuberculosis with lower respiratory infections and drug resistance are serious.So in patients with tuberculosis infection clinical antibiotic treatment should based on sensitivity tests.