【摘要】 目的探讨尘肺病合并下呼吸道感染患者的病原菌及菌株耐药情况,为指导临床合理用药提供参考。方法选择2013年1月至2014年12月该院收治的合并下呼吸道感染的尘肺病患者122例,采取口痰培养法收集相关标本后对其进行相关鉴定,采用K-B纸片扩散法进行药敏分析。结果 122例标本培养出病原菌82株,检出率67.21%(82/122),主要以革兰阴性杆菌为主,占70.7%,其中前3位依次为肺炎克雷伯菌(18.3%)、大肠埃希菌(15.9%)及铜绿假单胞菌(9.8%);革兰阳性球菌检出率为19.5%,其中肺炎链球菌(11.0%)、金黄色葡萄球菌(6.1%)及肠球菌(2.4%);真菌(白色念珠菌)检出率占9.8%;革兰阴性杆菌中对第二及第三代头孢菌素类药物有着较高的耐药性,其中以铜绿假单胞菌的耐药性最高,但对此类药物的复方制剂有着较高的敏感性,尤其对四代头孢类药物及碳青霉烯类的敏感性较高;革兰阳性球菌对第三及第四代头孢菌素类药物具有较高的耐药性,对替考拉宁、万古霉素具有较低的耐药性。结论尘肺病合并下呼吸道感染患者的主要病原菌为革兰阴性杆菌,且病原菌的耐药现象较为严重,临床给予持续耐药监测对于指导合理应用抗菌药物,提高治疗效果以及减缓耐药菌株的出现至关重要。更多还原

【Abstract】 Objective To investigate the pathogens and drug resistant strains in the patients with pneumoconiosis complicating lower respiratory tract infection to provide reference for guiding clinical rational drug use.Methods 122 cases of pneumoconiosis complicating lower respiratory tract infection admitted into our hospital from January2013 to December 2014 were selected.The sputum culture method was adopted to collected the related samples and conducted the related identification.Then the K-B paper diffusion method was taken for drug sensitivity analysis.Results Among 122 samples,82strains of pathogenic bacteria were cultured with the detection rate of 67.21%(82/122),which were dominated by Gram-negative bacilli,accounting for 70.7%,the top three in the order were Klebsiella pneumoniae(18.3%),E.coli(15.9%)and Pseudomonas aeruginosa(9.8%);the detection rate of Gram-positive coccus was 19.5%,including Streptococcus pneumoniae(11.0%),Staphylococcus aureus(6.1%)and Enterococcus(2.4%);the detection rate of Fungus(Candida albicans)was 9.8%;Gram-negative bacill had higher resistance to the second and the third generation of cephalosporin drugs,in which the drug-resistance of Pseudomonas aeruginosa was the highest,however,Gram-negative bacilli had high sensitivity to compound preparations,especially for the fourth generation cephalosporin and cabapenem drugs;Gram-positive cocci had higher drug-resistance to the third and fourth generation cephalosporin drugs and lower resistance to vancomycin and teicoplanin.Conclusion The main pathogenic bacteria were Gram-negative bacilli in the patients with pneumoconiosis complicating lower respiratory infection,and drug-resistance was relatively serious,the continuous clinical drug resistance monitoring in clinic is of crucial importance in guiding rational use of antibiotics,improving the treatment effect and reducing the emergence of resistant strains.更多还原