支气管肺部感染患者经痰标本细菌培养的情况分析

Analysis of Bacterial Culture of Sputum Specimens in Patients with Bronchopulmonary Infections

目的研究支气管肺部感染患者经痰标本细菌培养的检测价值。方法选取2019年1月-2022年1月我院诊治的56例支气管肺部感染患者为研究对象,均进行痰标本细菌培养,观察总结痰标本细菌分布情况、不同病情患者细菌分布情况、主要革兰阴性和阳性菌耐药性以及抗菌药物应用不良反应发生情况。结果56例患者共分离病原菌56株,其中革兰氏阳性10例、革兰氏阴性菌49例,且革兰氏阴性菌排名前4位的分别是肺炎克雷伯菌、铜绿假单胞菌、不动杆菌及大肠埃希菌;重症患者肺炎克雷伯菌检出率高于非重症患者(P<0.05),铜绿假单胞菌、大肠埃希菌检出率低于非重症患者(P<0.05),而不动杆菌、其他病原菌检出率与非重症患者比较,差异无统计学意义(P>0.05);主要革兰氏阴性菌株对利福平、四环素、万古霉素、替加环素、莫西沙星、阿米卡星、米诺环素、亚胺培南耐药性较弱,克林霉素、红霉素、青霉素、克拉霉素、阿奇霉素、头孢西丁、左氧氟沙星耐药性较强;依据细菌培养结果和耐药性选择合理抗菌药物,临床治疗合理用药率高达96.43%。结论支气管肺部感染患者进行痰标本细菌培养可明确主要病原菌,并针对耐药性结果选择合理抗菌药物治疗,促进临床疗效的同时,提高治疗安全性。

Objective To study the detection value of bacterial culture of sputum specimens in patients with bronchial pulmonary infection.Methods From January 2019 to January 2022,56 patients with bronchopulmonary infection diagnosed and treated in our hospital were selected as the research objects.All of them were cultured with sputum specimens.The bacterial distribution of sputum specimens,the bacterial distribution of patients with different conditions,the drug resistance of main Gram-negative and positive bacteria and the occurrence of adverse reactions of antibacterial drugs were observed and summarized.Results A total of 56 strains of pathogenic bacteria were isolated from 56 patients,including 10 strains of Gram-positive bacteria and 49 strains of Gram-negative bacteria.The top four Gram-negative bacteria were Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter and Escherichia coli.The detection rate of Klebsiella pneumoniae in severe patients was higher than that in non-severe patients(P<0.05),and the detection rates of Pseudomonas aeruginosa and Escherichia coli were lower than those in non-severe patients(P<0.05)while the detection rates of Acinetobacter and other pathogens were not significantly different from those in non-severe patients(P>0.05).The main Gram-negative strains had weak resistance to rifampicin,tetracycline,vancomycin,tigecycline,moxifloxacin,amikacin,minocycline and imipenem,and strong resistance to clindamycin,erythromycin,penicillin,clarithromycin,azithromycin,cefoxitin and levofloxacin.According to the results of bacterial culture and drug resistance,reasonable antibacterial drugs were selected,and the rational drug use rate in clinical treatment was as high as 96.43%.Conclusion Bacterial culture of sputum specimens in patients with bronchopulmonary infection can identify the main pathogens,and select reasonable antimicrobial therapy according to the results of drug resistance,so as to promote clinical efficacy and improve the safety of treatment.