SARS患者继发细菌性感染菌型及耐药性研究

Organism Distribution and Drug Resistance in Severe Acute Respiratory Syndrome with Secondary Bacterial Infection

目的 探讨 SARS患者继发细菌性感染的发病机理、病原菌菌型分布及耐药现状。方法 对本院收治 38例 SARS继发细菌性感染患者的痰液等标本中分离的 5 5株细菌进行菌型分类 ,体外作 MIC药敏试验并分析药敏结果。结果 共分离出 5 5株细菌 ,其中革兰阴性杆菌 2 5株 (非发酵菌 2 0株 ) ,革兰阳性球菌 2 0株 (凝固酶阴性葡萄球菌 13株 ) ,白色假丝酵母菌 10株 ;耐甲氧西林凝固酶阴性葡萄球菌 (MRCo NS) 9株 ,非发酵菌对三代头孢、四代头孢抗生素耐药率高达 5 8.8% ,白色假丝酵母菌对氟康唑均敏感。结论 SARS患者继发细菌性感染以非发酵菌为主 ,凝固酶阴性葡萄球菌次之 ,症状重者出现菌型变化或二重感染 ,菌群失调后有白色假丝酵母菌感染者 ;SARS患者继发细菌性感染对抗生素的耐药率较高 ,且可能发生菌型变化 ,应引起临床重视。

OBJECTIVE To study the nosogeny, organism distribution and current resistance of severe acute respiratory syndrome (SARS) patients with secondary bacterial infection. METHODS A total of 55 strains of bacteria from 38 SARS patients with secondary bacterial infection were classified and drug resistance was analyzed. RESULTS From 55 strains Gram negative bacteria were 25 strains [including 20 nonfermentative strains (NFS)]. Gram positive cocci were 20 strains [including 13 coagulase negative staphylococci (CoNS) strains, from which meticillin resistant coagulase negative staphylococci 9 strains] and Candida albicans were 10 strains and all sensitive to fluconazole. The resistance ratio of third and fourth qenerations cephalosporins for NFS was 58.8%. CONCLUSIONS NFS are the first main organisms of SARS patients with secondary bacterial infection. The next ones are CoNS and C. albicans. The resistance ratio is in an increasing tendency.