173例肺结核患者医院感染情况分析

Analysis of hospital infection of 173case pulmonary tuberculosis patients

目的：探讨肺结核患者医院感染菌群分布及耐药情况，更好的指导临床用药。方法：收集我院2010年1月～2013年11月治疗的1668例肺结核患者资料，其中其中发生医院感染173例，进行细菌学分析。结果：173例医院感染的肺结核患者，真菌44株，占25．45％；G＋球菌33株，占19．1％；G-杆菌96株，占55．8％。以革兰阴性杆菌为主，其次为真菌，G＋球菌位居第三。33株G＋球菌多数药物的的耐药率达75．8％，万古霉素的耐药率为0，44株真菌耐咪康唑16株，占36．4％，耐益康唑14株，占31．8％，耐酮康唑11株，25．0‰耐制霉菌素1株，占2．3‰耐两性霉素B1株，占2．3％，耐5-氟胞嘧啶1株，占2．3％。G-杆菌耐药率较高，氨苄西林、复方新诺明的耐药率在60％以上。结论：肺结核患者的各种细菌的耐药率较高，临床要根据药敏实验选择用药，减少药物的滥用。

Objective ： To investigate the distribution of tuberculosis bacteria in patients with nosocomial infection and drug resistance, a better guide clinical practice. Methods ： The hospital in January 2010- November 2013 Treatment of 1668 cases of tuberculosis patient data, including 173 cases of nosocomial infection which, for bacteriological analysis.Results ： 173 cases of hospital infection in tuberculosis patients, fungi 44, accounting for 25.45%; G ＋ cocci 33, accounting for 19.1%; G-bacteria 96, accounting for 55.8%. Gram-negative bacilli, followed by fungi, G ＋ cocci in third place. 33 G ＋ cocci majority of drug resistance rate of 75.8%, vancomycin-resistant strains of fungi resistant to miconazole was 0,44 16, 36.4%, resistance to econazole 14, 31.8%, resistance to ketoconazole 11, 25.0%, a resistance to nystatin, 2.3%, strains resistant to amphotericin B1, 2.3%, 52 flucytosine--resistant one, accounting for 2.3%. Higher rate of G-resistant bacteria, ampicillin, cotrimoxazole resistance rate of 60%. Conclusions ： TB patients with a higher rate of bacterial resistance, susceptibility testing according to selected clinical medicine to reduce drug abuse.