耐多药肺结核患者合并呼吸道感染的菌种分布及药敏分析

Analysis of the Distribution and Drug Sensitivity of Multi Drug Resistant Pulmonary Tuberculosis Patients Complicated With Respiratory Tract Infection

目的分析耐多药肺结核患者合并呼吸道感染的菌种分布及药敏结果。方法采集124例耐多药肺结核合并呼吸道感染患者的痰液标本进行病原学检测、鉴定及药敏分析。结果分离出菌株158株,革兰阴性菌106株(67.09%),真菌42株(26.58%),革兰阳性菌10株(6.33%),革兰阴性菌所占比例为首(P <0.05)。革兰阴性菌对常用抗菌药物亚胺培南、头孢匹胺的敏感性较高(P <0.05),真菌对常用抗菌药物伏立康唑、氟康唑、伊曲康唑的敏感性均较高,革兰阳性菌对常用抗菌药物万古霉素、利奈唑胺的敏感性较高(P <0.05)。结论耐多药肺结核患者合并呼吸道感染的病原菌以革兰阴性菌为主,且耐药现象严重,加强药敏分析对促进临床合理用药、提高疗效具有重要的作用。

Objective To analyze the distribution and drug sensitivity of multidrug-resistant pulmonary tuberculosis patients with respiratory tract infection. Methods Sputum samples from 124 patients with multidrug-resistant pulmonary tuberculosis complicated with respiratory tract infection were collected for etiological examination, identifcation and drug sensitivity analysis. Results 158 strains were isolated, 106 Gram-negative bacteria （67.09%）, 42 fungi （26.58%）, 10 Gram-positive bacteria （6.33%）, and Gram-negative bacteria （P 〈 0.05）. The sensitivity of Gram-negative bacteria to common antibiotics imipenem and cefpamine was higher （P 〈 0.05）. The sensitivity of fungi to common antibiotics voriconazole, fuconazole and itraconazole was higher. The sensitivity of Gram-positive bacteria to vancomycin and linezolid was higher （P 〈 0.05）. Conclusion The pathogenic bacteria of multi drug resistant pulmonary tuberculosis patients with respiratory tract infection are mainly Gram-negative bacteria, and the drug resistance is serious. Strengthening drug sensitivity analysis plays an important role in promoting the rational use of drugs and improving the curative effect.