肺结核患者合并肺感染的病原菌分布及耐药性分析

[目的]了解我院肺结核患者合并肺感染菌种的分布及临床特点、耐药性。[方法]对2005年1月～2006年5月月期间我院结核科的继发下呼吸道感染患者进行痰培养，采用VITEK-32全自动微生物鉴定系统进行鉴定和药敏分析。[结果]革兰阴性杆菌中主要以肺炎克雷伯菌为首位，其次是大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌和鲍曼不动杆菌。其中，肺炎克雷伯菌和大肠埃希菌产ESBLs率分别为32．5％和41．8％；对亚胺培南、丁胺卡那霉素、哌拉西林／他唑巴坦、头孢吡肟、妥布霉素等敏感。[结论]肺结核患者合并肺部感染应予重视。控制医院克雷伯菌感染并防止ESBLs的产生应及时进行痰培养，合理使用抗生素。

DISTRIBUTION AND DRUG RESISTANCE OF PATHOGENS IN PATIENTS WITH TB AND PULMONARY INFECTION

[ Objective] To investigate the distribution and drug resistance of pathogens in patients with TB and pulmonary infection in our hospital. [Methods] The sputum culture was performed in the patients with TB and pulmonary infection treated in our hospital from January 2005 to May 2006. The bacterial identification and drug resistance were conducted using the VITEK - 32 automatic microbial identification system. [ Results] The gram - negative bacilli included Klebsiella pneumoniae that was followed in order by E coli, Pseudomonas aeruginosa, Enterobacter cloacae and Acinetobacter. The ESBLs - producing rate was 32.5% and 41.8% for Klebsiella pneumoniae and E coli, respectively. [ Conclusion] We should pay close attention to TB complicated with pulmonary infection, control infection by Klebsiella pneumoniae in the hospital, prevent ESBLs production, timely conduct sputum culture and reasonably use antibiotics.