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目的观察分析联合检测肺炎支原体(Mp)和肺炎衣原体(Cp)对社区获得性肺炎(CAP)患者的临床意义。方法选取1500例CAP患者作为研究对象,对其咽拭子标本中的Mp和CpDNA进行检测,对主要病原菌进行培养和鉴定,观察比较患者的抗感染治疗方案和治愈率。结果本组CAP患者的病原体分布以Mp、肺炎链球菌、流感嗜血杆菌和Cp的比例最大,而感染类型以2种病原体感染的比例最多;在本组患者的治疗过程中,β-内酰胺类抗菌药物的使用频率最高,应用β-内酰胺类联合大环内酯类或氟喹诺酮类药物治疗的患者的治愈率显著高于单独应用β-内酰胺类药物的患者(P<0.05);在治疗Mp或Cp单纯感染时,单独应用β-内酰胺类药物与应用β-内酰胺类联合大环内酯类或氟喹诺酮类药物治疗的患者治愈率无显著性差异(P>0.05);在治疗细菌合并Mp或Cp感染时,应用β-内酰胺类联合大环内酯类或氟喹诺酮类药物的患者治愈率显著高于单独应用β-内酰胺类药物者(P<0.05)。结论Mp和Cp感染在CAP患者中比较多见,患者的主要感染类型是2种病原体的混合性感染,β-内酰胺类药物是治疗过程中常用药物,应用β-内酰胺类联合大环内酯类或氟喹诺酮类药物的抗感染方案可提高患者的治愈率,特别是在有细菌合并Mp或Cp感染时,可发挥显著疗效,临床医生应根据Mp或Cp的检测结果合理、有效地选择抗感染治疗方案。
Objective To investigate the clinical significance of combined detection of Mycoplasma pneumoniae (Mp) and Chlamydia pneumoniae (Cp) in patients with community-acquired pneumonia (CAP). Methods One hundred and fifteen patients with CAP were enrolled in this study. Mp and CpDNA in throat swab samples were detected, and the main pathogens were cultured and identified. The anti-infective treatment and cure rate were compared between the two groups. Results The distribution of pathogen in patients with CAP in this group was the largest among Mp, Streptococcus pneumoniae, Haemophilus influenzae and Cp, while the infection type was the most frequently infected with the two pathogens. During the course of treatment, β-lactam The highest frequency of antimicrobial agents was found in patients treated with β-lactams plus macrolides or fluoroquinolones compared with patients receiving β-lactam alone (P <0.05). In the treatment of Mp or Cp infection alone, there was no significant difference (P> 0.05) in the cure rate of patients treated with β-lactam alone and β-lactam combined with macrolides or fluoroquinolones. In the treatment of bacterial infection with Mp or Cp, the application of β-lactam combined with macrolides or fluoroquinolones cured patients were significantly higher than those with β-lactam alone (P <0.05). Conclusions Mp and Cp infection are more common in CAP patients. The main type of infection in patients is mixed infection of two kinds of pathogens, β-lactam drugs are commonly used in the treatment process, the application of β-lactam combined with macrocyclic Anti-infectives of esters or fluoroquinolones increase the cure rate in patients, especially when there is bacterial or Mp or Cp infection, and clinicians should make reasonable and efficient decisions based on the Mp or Cp test results Anti-infective treatment program.