脑血栓患者合并肺部感染痰细菌培养和药敏分析

目的：了解脑血栓患者合并肺部感染痰细菌菌裙的分布和体外药敏试验状况、耐药机制、合理指导应用抗生素。方法：脑血栓患者合并肺部感染的痰液做细菌培养，按常规方法分离应用MICROSCAN-4半自动细菌鉴定分析仪进行细菌鉴定到种并作药敏试验采用产色素头孢菌素法检测β-内酰胺酶（ESBLS）和双纸片协同实验做超广谱β-内酰胺酶初筛。结果：319例痰中分离到238例阳性，其中细菌株208株，酵母样真菌47株，合并感染42例，157例革兰氏阴性菌中产β-内酰胺酶（ESBLS）的肺炎克雷伯菌11株和产β-内酰胺酶的大肠杆菌5株，12株金黄色葡萄球菌中检出耐苯唑青霉素（MRCNS）的6株，在42株凝固酶阴性的表皮葡萄球菌中检出耐苯唑青霉素的24株。结论：脑血栓合并肺部感染的细菌种类多，菌谱复杂菌株呈多重耐药性。以非发酵菌感染占多数，铜绿假单胞菌位居首位，二重感染以合并酵母样真菌多见，革兰氏阳性球菌中耐苯唑青霉素的菌株占58．3％。

Cerebral thrombus patient merges the lungs to infect the phlegm bacilli culture and the medicine sensitive analysis

Objective:To explore cerebral thrombus patient merges the lungs to infect the phlegm bacterium fungus spectrum the distribution and in vitro medicine sensitive experiment condition,bears the medicine machine-made,the reasonable instruction application antibiotic.Methods:Cerebral thrombus patient merges the sputamentum which the lungs infect to make the bacilli culture,carries on the bacterium according to the conventional method separation using the MICROSCAN-4 semiautomatic bacterium appraisal analyzer to appraise the kind and to perform the medicine sensitive experiment,uses produces pigment cephalosporin law examination beta-lactan enzyme(ESBLS) and the double slip of paper coordination experiment makes the ultra broad spectrum beta-lactan at the beginning of enzyme to sieve.Results: From 319 cases of sputum samples,238 clinical isolates were obtained,including 208 strains of bacteria and 47 strains of fungi.In 42 cases there were mixed infections.Within the 157 strains of Gram-negative bacilli,there were 11 strains of ESBLs-producing K.pneunoniac and 5 strains of ESBLs-producing E.coli.6 strains of methecillin resistant staphylococcus(mrcns) were detected from 12 strains S.aureus,and 24 strains of methecillin resistant coagulase negative Staphylococcus(MRSA) from 42 strains of CNS.Conclusions: The species of the clinical isolates mentioned above were various.The bacterial strains showed multiple antibiotics resistance.Most of them belonged to non-fermenters and pseudomonas acruginosa was in the majority.The yeast-like fungi were common in the superinfection cases.The rate of MRSA strains in Gram-positive cocci was as high as 58.3%.