肺结核合并下呼吸道感染的病原菌谱分析

目的了解临床肺结核病人合并下呼吸道感染病原菌的分布及其耐药特点。方法对深圳市第三人民医院2009-2011年间临床确诊为肺结核病人的痰标本细菌培养结果进行分析。结果从临床确诊的结核病人中共分离出结核菌以外的病原菌213株,其中真菌占44.1%(94/213),革兰阴性杆菌占45.5%(97/213),革兰阳性球菌仅占10.3%(22/213)。肺结核病人并发下呼吸道感染的病原菌前5位依次为白假丝酵母菌、铜绿假单胞菌、流感嗜血杆菌、鲍氏不动杆菌和肺炎克雷伯菌肺炎亚种,药物敏感试验显示多数耐多种抗生素。结论肺结核合并下呼吸道感染病原菌的构成比与普通住院病人不同,以白假丝酵母菌和铜绿假单胞菌等耐多种抗生素条件致病菌为主。

Pathogenic analysis of the lower respiratory of the pulmonary tuberculosis patients

Objective To investigate the characteristics of distribution and antimicrobial drug resistance of pathogens which cause clinical lower respiratory infection in pulmonary tuberculosis patients. Methods The pathogens isolated from sputum of pulmonary tuberculosis patients between 2009 and 2011 in the Third Hospital of Shenzhen were analyzed. Results 213 pathogenic strains were isolated from sputum samples of patients diagnosed with tuberculosis. Fungus and gram-negative bacilli were the main pathogens which accounted for 44.1%(94 / 213) and 45.5%(97 / 213), respectively of the overall pathogens, while gram-positive coccus contributed 10.3%(22 / 213) only. The top five pathogens in the lower respiratory tract of the tuberculosis patients were Candida albicans, Pseudomonas aeruginosa, Haemohilus influenzae, Klebsiella pneumaniae and Acinetobacter baumannii. Conclusion The composition of pathogens in lower respiratory tract were different between pulmonary tuberculosis patients and general patients. Candida albicans and Pseudomonas aeruginosa, which were multipledrug resistant strains are the main pathogens in the lower respiratory tract of pulmonary tuberculosis patients.