768例肺结核患者下呼吸道感染致病菌耐药性探讨

Pathogens and their drug resistance analysis on 768 cases of pulmonary tuberculosis patients with lower respiratory tract infection

目的探讨肺结核患者合并下呼吸道感染的致病菌及其耐药性。方法对768例确诊的肺结核患者进行痰和／或支气管肺泡灌洗液进行细菌培养。结果革兰阴性菌596株，占58．1％，对哌拉西林／舒巴坦及头孢哌N／舒巴坦耐药率在5．7％-14．3％。革兰阳性菌201株，占19．6％，对万古霉素耐药率为0。真菌228株，占22．2％，对伊曲康唑耐药，耐药率为10．6％。结论肺结核患者下呼吸道感染，以革兰阴性菌为主，真菌比例呈上升趋势。

Objective To investigate the pathogenic bacteria causing lower respiratory tract infection and their drug resistance in pulmonary tuberculosis inpatients. Methods The sputum and/or bronchoalveolar lavage fluid sam- ples of diagnosed pulmonary TB inpatients were cultured. Results A total of 1,025 strains were obtained from the cultures. Among them 596 strains were Gram-negative bacilli （58.1%） , and their resistance rates to piperacillin- sulbactam and cefoperazone-snlbactam were from 5. 7% to 14. 3%. 201 strains were Gram-positive bacilli （ 19.6% ）, and their resistance rate to vancomycin was zero. 228 strains were fungi （22.2%） , and their resist- ance rate to itraconazole was 10.6%. Conclusion The Gram-negative bacilli are the major pathgens isolated from pulmonary tuberculosis patients with lower respritory tract infection ; the rate of fungi is markedly increasing.