系统性红斑狼疮伴发感染菌群及耐药性分析

Distribution of pathogens and their antibiotic resistance in systemic lupus erythematosus patients with infection

目的了解系统性红斑狼疮（SLE）住院患者的感染菌群及耐药情况，指导临床诊断、治疗。方法对2008年10月～2013年10月在金华市中心医院住院的SLE患者发生感染的菌株、耐药情况进行分析。结果432例患者中158例发生感染，感染发生率为36．6％；共培养到84株细菌，分布部位依次为呼吸道（40．5％）、泌尿生殖道（28．4％）、胃肠道（13．3％）；菌株构成比中以革兰阴性菌多见（41．7％），较常见的细菌为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌及表皮葡萄球菌，还有6例结核菌感染，2例死亡病例均合并有深部真菌感染。细菌药敏试验结果显示耐药菌株比例较高。结论对SLE患者应及早使用有效抗生素，须重视对真菌的预防，同时不要忽视结核病。

Objective To investigate distribution of pathogens and their resistance in systemic lupus erythematosus （SLE） patients with infection, in order to guide clinical diagnosis and treatment. Methods Patients with SLE admitted to Jinhua Central Hospital from October 2008 to October 2013 were reviewed, and the pathogens and the drug resistance of pathogenic bacteria were investigated. Results The prevalence of infection in 432 patients was 36.6% （158/432）. There were 84 strains detected. The common infection sites were respiratory tract （40.5%）, urogenital tract （28.4%） and gastrointestinal tract （13.3%）. The majority bacteria were gram-negative bacteria （41.7%）, E. coli, klebsiella tmeumoniae, staphylococcus aureus, pseudomonas aeruginosa and staphylococcus epidermis were the most common bactiria caused infection in SLE patients. There were 6 patients with tuberculosis. 2 cases of death cases were complicated with deep fungal infection. Antimicrobial susceptibility tests showed that the drug resistant rates were high. Conclusion Effective antibiotics should be used as soon as possible for SLE patients, fungi should be prevented, at the same time don＇t ig- nore tuberculosis.