药敏试验对支气管扩张合并肺部感染患者的抗菌药物合理应用的影响

Influence of Drug Sensitive Test on Rational Use of Antibacterial Drugs in Patients with Bronchiectasis and Pulmonary Infection

目的:分析支气管扩张合并肺部感染患者药敏结果及病原菌分布情况,探讨其指导抗菌药物合理应用的重要性。方法:选取2019年1月—2021年12月玲珑英诚医院(山东大学第二医院招远分院)收治的支气管扩张合并肺部感染患者100例为观察对象,采集样本,培养病原菌,进行菌种鉴定和药敏试验,分析致病菌的感染类型、常见致病菌在临床上分布情况,分析用药合理性相关影响因子。结果:100例患者中痰液样本阳性31例,阳性率为31.00%,分离出菌株90株,包括革兰阴性菌65株,占72.22%;革兰阳性菌25株,占27.78%;复方磺胺甲唑、头孢曲松、头孢替坦、氨苄西林的产超广谱β-内酰胺酶菌耐药率均为100%,环丙沙星耐药率为94.74%;注射剂药物中复方磺胺甲唑、左氧氟沙星药物利用指数>1,其余各种药物的药物利用指数≤1;感染病原菌类型、产超广谱β-内酰胺酶菌、药敏用药、药物类型为用药合理性的影响因子(P<0.05)。结论:支气管扩张并发肺部感染患者致病菌类型多样,临床治疗过程中可借助药敏试验进一步明确致病菌类型,为治疗方案的制定提供准确参考,确保抗菌药物的合理应用。

Objective:To analyze the results of drug sensitivity and the distribution of pathogenic bacteria in patients with bronchiectasis and pulmonary infection,and explore its importance in guiding the rational use of antibacterial drugs.Methods:A total of 100 patients with bronchiectasis complicated with pulmonary infection admitted to Linglong Yingcheng Hospital(Zhaoyuan Branch,the Second Hospital of Shandong University)between January 2019 to December 2021 were collected as the study subjects.Samples were collected,pathogenic bacteria were cultivated,strains were identified and drug sensitivity tests were conducted.The infection types of pathogenic bacteria and the distribution of common pathogenic bacteria in clinic were analyzed.The related influencing factors of the rationality of drug use was analyzed.Results:Among 100 patients,sputum samples were positive in 31 patients,and the positive rate was 31.00%;90 strains were isolated,including 65 strains of gram-negative bacteria,accounting for 72.22%,and 25 strains of gram-positive bacteria,accounting for 27.78%.The resistance rate of compound sulfamethoxazole,ceftriaxone,cefotetan and ampicillin was 100%for extended spectrum beta lactamase producing bacteria,and the resistance rate of ciprofloxacin was 94.74%.Among the injection drugs,the drug utilization index of compound sulfamethoxazole and levofloxacin was>1,and the drug utilization index of other drugs was≤1;The type of infectious pathogenic bacteria,extended spectrum beta lactamase producing bacteria,drug susceptibility,and drug type were the influencing factors of drug use rationality(P<0.05).Conclusion:There are various types of pathogenic bacteria in patients with bronchiectasis complicated with pulmonary infection.During clinical treatment,drug sensitivity test can be used to further clarify the type of pathogenic bacteria,provide accurate reference for the formulation of treatment plan,and ensure the rational use of antibacterial drugs.