肺结核合并下呼吸道感染病原菌调查及药物敏感分析

目的了解肺结核合并下呼吸道感染患者痰培养病原菌构成，药敏试验结果，以期给疾病治疗带来帮助。方法对肺结核患者应用常规痰培养方法检测病原菌，对阳性结果作体外药敏试验。结果共获得病原菌106株，以革兰氏阴性菌为主，共63株，革兰氏阳性菌14株，霉菌29株，分别占59．43％、13．21％、27．36％。革兰氏阴性菌中，以铜绿假单胞菌，肺炎克雷伯氏菌，大肠埃希氏菌为主。革兰氏阳性菌中，以葡萄球菌为主。对革兰氏阴性菌敏感率高的抗生素是头孢吡肟，头孢他定，亚胺培南，阿米卡星等。对革兰氏阳性菌敏感率较高的抗生素是万古霉素、氟喹诺酮类抗生素以及一、二代头孢菌素。结论肺结核合并下呼吸道感染患者痰培养病原菌主要仍为革兰氏阴性菌，可使用头孢三代抗生素、氟喹诺酮类抗生素。对少数革兰氏阳性菌感染者，则可使用氟喹诺酮类抗生素、一、二代头孢菌素等。头孢三代抗生素、氟喹诺酮类、氨基糖甙类抗生素可作为临床治疗的经验用药。

Pathogen analysis and antimicrobial susceptibility on concurrent lower respiratory tract infection in patients with pulmonary tuberculosis

Objective To investigate the characteristics of the distribution and drug susceptibility of pathogenic bacteria in lower respiratory tract of pulmonary tuberculosis cases.Methods The 106 isolated strains from tuberculosis patients accompanied with lower respiratory infection in our hospital during October 2006 to February 2007 for gem species identification and drug sensitivity test in vitro.Results A total of 106 pathogenic bacteria strains were isolated.There were 63 strains of gram negative bacteria(59.43%);14 strains(13.21%) were gram positive bacteria;29 strains(27.36%) were fungi.The primary gram negative bacteria were pseudomonas aeruginosa klebsiella pneumoniae and E.coli.Most of the gram negative bacteria were highly sensitive to Amikacin Cefepime Ceftazidime and Imipenem.The primary gram positive bacteria were staphylococcus which sensitive to vancomycin quinolone the first and the second generation cephalosporin.Conclusion The primary pathogenic bacteria were gram negative bacteria in lower respiratory tract of the patients with pulmonary tuberculosis.The third generation cephalosporin and quinolone should be used as the first choice in the experiential therapy for lower respiratory tract infection in patients with pulmonary tuberculosis.