住院肺结核患者发生院内肺部感染的临床研究

Clinical study of 72 inpatients with pulmonary TB complicated with pulmonary infection

目的探讨住院肺结核继发院内肺部感染的易感因素、病原谱及干预。方法分析研究感染和对照组的结核本病与院内肺部感染特征。结果继发感染与年龄、初复治或耐药、病灶无关,与合并糖尿病、基础肺病、营养和曾用抗生素有关。病原主要为革兰氏阴性菌(G-)、真菌、革兰氏阳性菌(G+),非结核分枝杆菌。G-中前三位依次为肺炎克雷伯、铜绿假单胞菌和肠杆菌。结论有糖尿病、基础肺病、营养不良、久用抗生素者易发肺部感染。

Objective To investigate the risk factors, infectious organisms and intervene approach for hospital-acquired pulmona- ry infection in pulmonary tuberculosis （PTB） inpatients. Methods The features of pulmonary infection were compared and analyzed be- tween the infection group and the control group. Re.suits The secondary infection had no relation with patientsJage, first or re-treatment, drug resistant of PTB and TB lesion, but it was related with coexist with diabetes, pulmonary diseases, nutritional condition, and antibiot- ics. The TB patient who coexist with diabetes, existing pulmonary diseases, malnutrition, be treated with antibiotics extended over two weeks very easy to get hospital infection. The main pathogen was gram-negative bacteria, followed by fungus, gram-positive bacteria and nou-tuberculosis mycobacteria. The top three kinds of bacteria in gram-negative bacteria were Klebsiella pneumonia, pseudomonas aerugi- nosa and cnterobacter. Conclusion The patients with diabetes, other pulmonary diseases, poor nutritional condition, and long time use of antibiotics are easily to have pulmonary infection.