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目的探讨菌阴肺结核合并糖尿病患者呼吸系统革兰氏阴性杆菌病原菌分布及对药敏结果进行分析。方法对住院菌阴肺结核合并糖尿病患者痰标本分离所得168例革兰氏阴性杆菌病原菌分布及药敏结果进行分析。结果 168例革兰氏阴性杆菌中:肺炎克雷伯菌45例、铜绿假单胞菌32例、鲍曼不动杆菌17例、阴沟肠杆菌15例、大肠埃希菌9例、嗜麦芽窄食单胞菌7例、其他革兰氏阴性杆菌43例。肺炎克雷伯菌和大肠埃希菌中产ESBLs分别为:7例、5例。碳青霉烯类是肠杆菌科中耐药率最低的,耐药率较低的还有阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、氨曲南、莫西沙星等。结论菌阴肺结核合并糖尿病患者下呼吸道感染革兰氏阴性杆菌耐药现象严重,应尽量避免不合理应用抗生素而加大细菌耐药性。
Objective To investigate the distribution of respiratory gram-negative bacilli in patients with bacterial vaginosis combined with diabetes mellitus and to analyze the drug susceptibility results. Methods The distribution and drug susceptibility of 168 Gram-negative bacilli isolated from sputum samples from hospitalized patients with negative pulmonary tuberculosis and diabetes mellitus were analyzed. Results Of 168 Gram-negative bacilli, 45 were Klebsiella pneumoniae, 32 were Pseudomonas aeruginosa, 17 Acinetobacter baumannii, 15 were Enterobacter cloacae, 9 were Escherichia coli, Staphylococcus aureus in 7 cases, other Gram-negative bacilli in 43 cases. ESBLs production in Klebsiella pneumoniae and Escherichia coli were 7 and 5, respectively. Carbapenems are the lowest rate of resistance in Enterobacteriaceae, amikacin, piperacillin / tazobactam, cefoperazone / sulbactam, aztreonam, Moxifloxacin and others. Conclusion Gram-negative bacilli were found to be resistant to lower respiratory tract infections in patients with bacterial vaginosis and diabetes mellitus, and should be avoided by unreasonable use of antibiotics.