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目的探讨结核科与呼吸科下呼吸道感染的病原菌分布及耐药率差别,为临床医师合理应用抗菌药物提供依据。方法收集2013年7月—2014年7月结核科与呼吸科患者送检的痰液及灌洗液标本,采用VIT EK-32全自动微生物鉴定系统对病原菌进行鉴定及药敏试验,并用SPSS 17.0软件进行数据分析。结果结核科与呼吸科的病原菌构成以及耐药率有一定的差异。肺炎克雷伯菌、铜绿假单胞菌、产酸克雷伯菌在结核科和呼吸科细菌分布上存在统计学差异(P分别为0.002,0.000,0.044);肺炎克雷伯菌在结核科和呼吸科对常用抗菌药物的耐药率相似;铜绿假单胞菌在呼吸科的耐药率高于结核科;鲍曼不动杆菌在呼吸科的耐药率明显高于结核科;甲氧西林敏感金黄色葡萄球菌在结核科和呼吸科对常用抗菌药物的耐药率相似,未出现耐甲氧西林金黄色葡萄球菌。结论肺结核患者与非结核患者罹患下呼吸道感染的细菌分布及耐药性均有所不同,临床医师应掌握本科室病原菌分布及耐药率情况,才能正确合理应用抗菌药物。
Objective To investigate the distribution of pathogenic bacteria and the rate of drug resistance in lower respiratory tract infection of tuberculosis and respiratory department and provide basis for clinicians to use antibacterial drugs reasonably. Methods The samples of sputum and lavage fluid collected from patients in the Department of Tuberculosis and Respiratory Diseases from July 2013 to July 2014 were collected. The pathogenic bacteria were identified and susceptible tested by VIT EK-32 automatic microbe identification system. SPSS 17.0 Software for data analysis. Results Tuberculosis and Respiratory Section of the pathogenic bacteria composition and resistance rates have some differences. Klebsiella pneumoniae, Pseudomonas aeruginosa, Klebsiella oxytoca in the distribution of tuberculosis and respiratory bacteria there is a statistically significant difference (P 0.002,0.000,0.044, respectively); Klebsiella pneumoniae in tuberculosis And respiratory department commonly used antimicrobial resistance rates similar to; Pseudomonas aeruginosa respiratory resistance rate is higher than that of tuberculosis; Acinetobacter baumannii respiration rate was significantly higher than tuberculosis; methoxy Xilin resistant Staphylococcus aureus in tuberculosis and respiratory medicine commonly used antimicrobial resistance rates similar to no methicillin-resistant Staphylococcus aureus. Conclusion The bacterial distribution and drug resistance of patients with pulmonary tuberculosis and non-tuberculosis patients with lower respiratory tract infection are different. Clinicians should master the distribution and drug resistance rate of pathogenic bacteria in their departments to apply the antibacterials correctly and reasonably.