感染性间质性肺炎病原体分布特点及耐药分析

Distribution characteristics and drug resistance of pathogens in patients with infectious interstitial pneumonia

目的分析感染性间质性肺炎患者病原体分布特点及其耐药性。方法选取78例感染性间质性肺炎患者,对其痰标本、咽拭子标本进行细菌培养及药敏试验,统计分析78例间质性肺炎患者病原体分布特点及其耐药性。结果 78例患者共检出病原体134株,其中32例为单一病原体感染,46例为多重病原体感染。病原体以革兰阴性菌多见,共检出57株(42.54%),肺炎支原体35株(26.12%),革兰阳性菌25株(18.66%),真菌9株(6.72%),巨细胞病毒8株(5.97%)。主要革兰阴性菌中,铜绿假单胞菌、副流感嗜血杆菌、肺炎克雷伯菌对庆大毒素、磺胺甲恶唑/甲氧苄啶、红毒素、氨曲南、阿莫西林/克拉维酸、哌拉西林的耐药率均高于50%,铜绿假单胞菌对阿米卡星(16.67%)、头孢吡肟(16.67%)、亚胺培南(0%)、美罗培南(0%)敏感;副流感嗜血杆菌对头孢哌酮/舒巴坦(11.76%)、阿米卡星(11.76%)、头孢他啶(29.41%)、亚胺培南(0%)、美罗培南(0%)敏感;肺炎克雷伯菌对阿米卡星(30.77%)、头孢他啶(23.08%)、亚胺培南(0%)、美罗培南(0%)敏感。主要革兰阳性菌中的肺炎链球菌对青霉素G、氨苄西林、磺胺甲恶唑/甲氧苄啶的耐药率较高,对万古霉素(0%)、利奈唑胺(0%)敏感。结论间质性肺炎以细菌感染为主,其次是肺炎支原体感染,而抗生素耐药比较普遍,了解间质性肺炎病原体分布及耐药对临床用药有重要的指导意义。

Objective To analyze the distribution characteristics and drug resistance of pathogens in patients with infectious interstitial pneumonia. Methods Totally 78 patients with infectious interstitial pneumonia were selected. The sputum samples and throat swab samples were cultured and drug sensitivity test was conducted. The distribution characteristics and drug resistance of pathogens in 78 patients with interstitial pneumonia were statistically analyzed. Results A total of 134 strains of pathogens were detected in 78 patients,including 32 cases of single pathogen infection and 46 cases of multiple pathogen infection. The most common pathogens were Gram-negative bacteria,including 57 strains( 42. 54%),and 35 strains were mycoplasma pneumoniae( 26. 12%),25 strains were Gram-positive bacteria( 18. 66%),9 strains were fungus( 6. 72%),and 8 strains were cytomegalovirus( 5. 97%). Among the main Gram-negative bacteria,drug resistance rates of Pseudomonas aeruginosa,Haemophilus parainfluenzae and Klebsiella pneumoniae were more than 50% resistant to gentamicin,sulfamethoxazole/trimethoprim,erythrotoxin,aztreonam,amoxicillin/clavulanic acid and piperacillin. Pseudomonas aeruginosa was sensitive to amikacin( 16. 67%),cefepime( 16. 67%),imipenem( 0%) and meropenem( 0%). Haemophilus parainfluenzae was sensitive to cefoperazone/sulbactam( 11. 76%),amikacin( 11. 76%),ceftazidime( 29. 41%),imipenem( 0%) and meropenem( 0%). Klebsiella pneumoniae was sensitive to amikacin( 30. 77%),ceftazidime( 23. 08%),imipenem( 0%) and meropenem( 0%). Streptococcus pneumoniae of the main Gram-positive bacteria showed high resistance to penicillin G,ampicillin and sulfamethoxazole/trimethoprim,and sensitive to vancomycin( 0%) and linezolid( 0%). Conclusion Bacterial infection is the main cause of interstitial pneumonia,followed by Mycoplasma pneumoniae infection,and antibiotic resistance is common. Understanding the pathogen distribution and drug resistance of interstitial pneumonia has an important guiding significance for clinical medication.