肺结核患者病原菌感染特点及耐药性

Characteristics and drug resistance of pathogens in patients with pulmonary tuberculosis

目的探讨肺结核患者病原菌感染分布特点及耐药性,根据其病原菌感染对临床用药进行指导分析。方法选取2009年3月-2012年3月收治的肺结核和非肺结核患者各290例,分为试验组和对照组,将580例患者采集的痰液进行普通菌培养,并将两组患者痰液培养结果进行分析比较。结果试验组患者检出病原菌153株,其中革兰阴性菌、革兰阳性菌、真菌分别占64.05%、26.14%、9.81%,对照组检出病原菌75株,革兰阴性菌、革兰阳性菌、真菌分别占57.33%、20.00%、22.67%,革兰阴性菌与革兰阳性菌检出株数均高于对照组;试验组革兰阳性菌中金黄色葡萄球菌与表皮葡萄球菌对庆大霉素、红霉素、环丙少星的耐药率分别为88.21%、82.11%、81.23%与65.34%、61.46%、63.19%,试验组革兰阴性菌中大肠埃希菌与铜绿假单胞菌对磺胺甲噁唑/甲氧苄啶、头孢西丁、头孢唑林的耐药率分别为88.45%、82.10%、57.10%与52.78%、88.45%、67.59%。结论肺结核患者病原菌分布比非肺结核患者更加广泛,且耐药性更强。

OBJECTIVE To discuss the distribution characteristics and drug resistance of pathogens in patients with tuberculosis, and to proceed guidance and analysis for clinical medication according to infection situation of pathogens. METHODS A total of 290 patients with tuberculosis and non-tuberculosis from Mar. 2009 to Mar. 2012 at our hospital were selected, and were divided into the trial group and the control group. Common bacteria culture was performed on the sputum collected in 580 patients, and sputum culture results of patients in the two groups were compared and analyzed. RESULTS In the trial group, 153 strains of positive pathogens were detected in the patients, of which gram-negative bacteria, gram-positive bacteria and fungi accounted for 64.05 %, 26.14 % and 9.81% respectively, and 75 strains of pathogens were detected in the control group, and the ratios of gram- negative bacteria, gram-positive bacteria and fungi were 57.33 %, 20.00 %, 22.67 %. The ratios of gram-negative bacteria and gram-positive bacteria were higher than that in the control group. The drug resistance rates of Staph- ylococcus aureus and S. epidermidis in the trial group to gentamicin, erythromycin, ciprofloxacin were 88.21 %, 82. 11 %, 81.23% and 65.34% ,61.46% ,63.19%. In the trial group, the drug resistance rates of Escherichia coli and Pseudomonas aeruginosa among gram-negative bacteria to sulfamethoxazole/trimethoprim, cefoxitin, cefazolin were 88.45%, 82.10%, 57.10% and 52.78%, 88.45%, 67.59%, respectively. CONCLUSION The distribution of pathogens in the patients with tuberculosis is more extensive than that in the patients with non-tuberculosis, and the drug resistance is much stronger.