论文部分内容阅读
目的:分析肺结核伴下呼吸道感染患者痰液中病原菌的分布及其药敏结果。方法:选取2013年5月—2014年12月间收治的肺结核伴下呼吸道感染住院患者140例作为研究对象,收集痰液标本进行病原菌与药敏分析。结果:140例肺结核伴下呼吸道感染患者中,48例为初治组患者(其痰液经培养结果示56株为病原菌),92例为复治组患者(其痰液经培养结果示102株病原菌);两组患者均以革兰阴性杆菌感染为主,分别占69.64%(39/56)与64.71%(66/102),其中初治组患者副流感嗜血杆菌感染率明显高于复治组(P<0.05);初治组患者革兰阴性菌对亚胺培南、头孢匹美、氨曲南等具有较高敏感性,而复治组患者革兰阴性菌对亚胺培南、头孢匹美、头孢他啶的敏感性较高;初治组患者革兰阳性菌对万古霉素、利奈唑胺、阿奇霉素有较高敏感性,而复治组患者革兰阳性菌对万古霉素、利奈唑胺敏感性较高。结论:肺结核伴下呼吸道细菌感染患者可结合细菌培养及药敏试验结果合理选用第3、4代头孢菌素与万古霉素或阿奇霉素联用对革兰阳性菌的疗效较好,确保抗生素使用的合理性和科学性。
Objective: To analyze the distribution and drug susceptibility of pathogens in sputum from patients with pulmonary tuberculosis and lower respiratory tract infection. Methods: A total of 140 inpatients with pulmonary tuberculosis and lower respiratory tract infection admitted to our hospital from May 2013 to December 2014 were selected as research objects. Sputum samples were collected for pathogenic bacteria and drug susceptibility analysis. Results: Of the 140 patients with pulmonary tuberculosis and lower respiratory tract infection, 48 were newly diagnosed patients (sputum culture results showed that 56 were pathogenic bacteria), and 92 patients were treated with Fuji (sputum culture showed 102 (69.64% (39/56) and 64.71% (66/102) respectively). The infection rate of Haemophilus parainfluenzae in newly diagnosed group was significantly higher than that in the untreated group (P <0.05). Gram-negative bacteria in newly diagnosed group were highly sensitive to imipenem, cefpirome, aztreonam and so on, whereas gram-negative bacteria in retreatment group had higher sensitivity to imipenem , Cefpirome, ceftazidime higher sensitivity; Gram-positive bacteria in patients with newly diagnosed group of vancomycin, linezolid, azithromycin have a higher sensitivity, and retreatment group patients Gram-positive bacteria vancomycin, Linezolid is more sensitive. Conclusion: Patients with pulmonary tuberculosis and lower respiratory tract bacterial infection can be combined with bacterial culture and drug susceptibility test results. The rational use of 3rd and 4th generation cephalosporins in combination with vancomycin or azithromycin has a good effect on Gram-positive bacteria and ensures the use of antibiotics Reasonable and scientific.