ICU继发性肺结核患者下呼吸道感染病原菌分布及耐药性分析

目的 了解深圳、龙岗、光明和龙华新区四家三级区属医院ICU继发性肺结核患者并发下呼吸道感染的病原菌分布特征及其耐药性现状,为临床诊断和合理选用抗生素治疗提供参考依据。方法 对随机选取2013年2月～2015年10月在三家区属医院ICU确诊为继发性肺结核并发下呼吸感染患者593例的痰标本病原菌培养和药敏结果进行回顾性分析。结果 593例ICU继发性肺结核并发下呼吸道感染患者中共分离出617株病原菌,其中真菌占49.6%(306/617),革兰阴性杆菌占40.4%(249/617),革兰阳性球菌占10.0%(62/617); 真菌感染主要病原体为白色假丝酵母菌和光滑假丝酵母菌,分别占44.2%(273/617)和4.5%(28/617),革兰阴性杆菌主要为肺炎克雷伯菌、铜绿假单胞菌及流感嗜血杆菌,分别占16.7%(103/617),12.0%(74/617)及7.3%(45/617),革兰阳性球菌主要为金黄色葡萄球菌、表皮葡萄球菌及溶血葡萄球菌,分别占4.5%(28/617),3.2%(20/617)及0.9%(5/617); 分离出的病原菌为多药耐药菌,对常用抗菌药物呈现不同程度的耐药性。结论 ICU继发性肺结核患者并发下呼吸道感染的病原菌以真菌和革兰阴性杆菌多见,最常见为白色假丝酵母菌、肺炎克雷伯菌及铜绿假单胞菌,且对常用抗菌药物产生不同程度的耐药性。

ICU Patients with Secondary PulmonaryTuberculosis Merger Lower Respiratory Infection of PathogenicBacteria Distribution and Drug Resistance Analysis

Objective To understand Shenzhen Longgang,guangming and longhua new district four district hospital ICU patients with secondarypulmonary tuberculosis merger lower respiratory infection of pathogenic bacteria distribution and drug resistance status of provide a reference for clinical diagnosis and rational use of antibiotics therapy.Methods Random selection from February 2013 to October 2015 in the three district hospital ICU diagnosis of secondary pulmonary tuberculosis patients with lower respiratory infection in 593 cases of sputum specimen pathogenic bacteria culture and drug susceptibility results were retrospectively analyzed.Results 593 cases of ICU secondary pulmonary tuberculosis patients with respiratory tract infection of the communist party of China isolated 617 strains of pathogenic bacteria,fungi accounted for 49.6%(306/617),gram negative bacilli accounted for 40.4%(249/617),gram positive cocci accounted for 10.0%(62/617).Fungal infection main pathogens for white smooth candida yeast and candida yeast,respectively accounted for 44.2%(273/617)and 4.5%(28/617),gram negative bacillus mainly Klebsiella Pneumoniae,Pseudomonas aeruginosa,and H.influenzae,respectively accounted for 16.7%(103/617),12.0%(74/617)and 7.3%(45/617),gram-positive cocci mainly for Saphylococcus aureus and Epidermis staphylococcus and Hemolytic staphylococci,respectively accounted for 4.5%(28/617),3.2%(20/617)and 0.9%(5/617).Pathogenic bacteria isolated from the multiple drug resistant bacteria,present different levels of resistance to commonly used antimicrobial agents.Conclusion ICU patients with secondary pulmonary tuberculosis merger of lower respiratorytract infection pathogens to fungi and gram-negative bacilli,the most commonWhite candida,Klebsiella pneumoniae,and Pseudomonas aeruginosa,and different levels of resistance to commonly used antimicrobial agents.