耐多药肺结核患者并发呼吸道感染的病原菌分布及耐药性分析

Analysis on Pathogenic Bacteria Distribution and Drug Resistance in Patients with Multi-Drug Resistant Tuberculosis Complicated with Respiratory Tract Infection

目的分析耐多药肺结核患者并发呼吸道感染的病原菌分布及耐药性。方法选择2016年10月至2021年10月我所收治的肺结核并发呼吸道感染患者180例,将94例复治经药敏试验确诊耐多药肺结核患者作为观察组,86例初治患者作为对照组,两组均采用全自动微生物分析仪进行病原菌检测,并行病原菌的药敏试验,比较两组的检测结果。结果观察组革兰阴性菌对舒巴坦、氨曲南、头孢唑林、阿莫西林敏感性显著低于对照组(P<0.05)。观察组革兰阳性菌对青霉素、克林霉素、万古霉素敏感性显著低于对照组(P<0.05)。结论耐多药肺结核患者并发呼吸道感染的病原菌分布以革兰阴性菌多见,对舒巴坦、氨曲南、克林霉素和万古霉素等常见抗菌药物耐药性强,需加强用药管理。

Objective To analyze the pathogenic bacteria distribution and drug resistance in patients with multi-drug resistant tuberculosis complicated with respiratory tract infection.Methods 180 patients with pulmonary tuberculosis complicated with respiratory tract infection admitted to our institute from October 2016 to October 2021 were selected.94 retreated patients with multi-drug resistant tuberculosis diagnosed by drug sensitivity test were selected as observation group,and 86 patients treated initially were selected as control group.The automatic microbial analyzer was used to detect the pathogens in two groups,and the drug sensitivity tests of pathogens were conducted.The detection results of the two groups were compared.Results The sensitivity of Gram negative bacteria to sulbactam,aztreonam,cefazolin and amoxicillin in the observation group was significantly lower than that in the control group(P<0.05).The sensitivity of Gram positive bacteria to penicillin,clindamycin and vancomycin in the observation group was significantly lower than that in the control group(P<0.05).Conclusions The distribution of pathogenic bacteria in patients with multi-drug resistant tuberculosis complicated with respiratory tract infection is more common with Gram-negative bacteria,and it is highly resistant to common antibacterial drugs such as sulbactam,aztreonam,clindamycin and vancomycin,so drug management should be strengthened.