支气管扩张症合并肺部感染患者的病原菌菌群分布及耐药性分析

Analysis on Distribution of Pathogenic Bacterial Flora and Drug Resistance in Patients with Bronchiectasis Complicated with Pulmonary Infection

目的:探讨支气管扩张症合并肺部感染患者的病原菌菌群分布及其对抗菌药物的耐药性,指导临床合理应用抗菌药物。方法:选择2017年1月至2018年11月佛山市第五人民医院收治的支气管扩张症合并肺部感染患者60例(观察组)、无基础肺病的肺部感染患者60例(对照组),均进行细菌培养、药物敏感试验,比较两组患者的病原菌分布及其药物敏感试验结果。结果:观察组患者检出病原菌60株,其中革兰阴性杆菌占65.00%(39株),革兰阳性球菌占35.00%(21株);对照组患者检出病原菌60株,其中革兰阴性杆菌占55.00%(33株),革兰阳性球菌占45.00%(27株);两组患者病原菌菌群分布的差异无统计学意义(P>0.05);观察组患者中检出的肺炎克雷伯菌占31.67%(19株),明显高于对照组的13.33%(8株),差异有统计学意义(P<0.05)。观察组、对照组患者检出的病原菌均对青霉素几乎耐药,而对美罗培南、亚胺培南及万古霉素较敏感,差异无统计学意义(P>0.05)。结论:支气管扩张症合并肺部感染患者的病原菌以革兰阴性杆菌为主,耐药情况较严重,临床医师须结合药物敏感试验结果合理选用抗菌药物。

OBJECTIVE: To probe into the distribution of pathogenic bacterial flora and drug resistance in patients with bronchiectasis complicated with pulmonary infection, so as to guide clinical application of antibiotics. METHODS: 60 patients with bronchiectasis complicated with pulmonary infection(observation group) and 60 patients with pulmonary infection without basic lung disease(control group) admitted into the Fifth People’s Hospital of Foshan from Jan. 2017 to Nov. 2018 were selected, both groups were conducted bacterial culture and drug sensitive tests, the distribution of pathogenic bacteria and results of drug sensitive tests of two groups were compared. RESULTS: 60 strains of pathogenic bacteria were detected in the observation group,Gram-negative bacilli was detected in 65.00%(39 strains) of patients, and Gram-positive coccus was detected in the rest 35.00%(21 strains);60 strains of pathogenic bacteria were detected in the control group, Gram-negative bacilli was detected in 55.00%(33 strains) of patients, and Gram-positive coccus was detected in the rest 45.00%(27 strains);there was no statistical significance in difference in the distribution of pathogenic bacteria between two groups(P>0.05). In the observation group, Klebsiella pneumoniae were detected in 31.67%(19 strains) of patients, which was significantly higher than that of the control group(13.33%, 8 strains), with statistically significant difference(P<0.05). The pathogenic bacteria detected in observation group and control group were almost resistant to penicillin, but sensitive to meropenem, imipenem and vancomycin, the difference had no statistical significance(P>0.05). CONCLUSIONS: The pathogenic bacteria of patients with bronchiectasis complicated with pulmonary infection are mainly Gram-negative bacilli, with serious drug resistance, clinicians must choose antibiotics in combination with the results of drug sensitivity test.