肺结核医院下呼吸道感染的病原菌及危险因素分析

目的 :探讨肺结核并医院内下呼吸道感染的主要病原菌和危险因素。方法 :以 46例肺结核并医院内下呼吸道感染病例 (院感组 )的痰培养结果与空气培养结果比较 ,并以院感组与住院对照组 (对照组 )在年龄、病程、病灶范围 ,合并症、治疗措施、抗菌药物使用、住院时间、免疫功能 8个方面进行回顾对比分析。统计学处理用计数资料 χ2检验。结果 :院感组痰培养以 G-杆菌为主占 5 6 .7% ,与空气培养 G-杆菌为 9.8% ,差别有显著性 P <0 .0 0 1;院感组与对照组在年龄等 8方面的差别均有显著性 P <0 .0 5至 P <0 .0 0 1。结论 :肺结核并医院内下呼吸道感染主要是自身条件致病菌感染 ,以 G- 杆菌感染为主 ,周围环境的影响不是主要因素 ,而与自身基础疾病因素、住院治疗因素、免疫功能有关。

Analysis on the pathogenic bacterium and sensitive factors of pulmonarytuberculosis with hospital infection in lower respiratory tract

Objective: To study the main pathogenic bacterium and sensitive factors of pulmonary tuberculosis with hospital infections in lower respiratory tract. Methods: 46 cases sputum culture result of pulmonary tuberculosis with hospital infections in lower respiratory tract (hospital infections group) were compared with air bacteria culture result. Eight factors (age,course of disease, focal range, complication,therapeutic principle, antibiotic therapy,course of hospitalization and immunology function) in two groups were analysed retrospectively Results:Hospital infections group was 56.7% positive of gram negative bacilli (G-),comparing with air bacteria culture 9.8%(P＜0.001). The significant differences in all eight factors between hospital infections group and control group. (P＜0.05～P＜0.001). Conclusion: Pulmonary tuberculosis with hospital infection in lower respiratory tract was infected mainly by G- bacilli which was caused by opportunistic pathogen of the original diseases, the environmental factor was not the main factor, while the primary disease, treatment and immunity functions were relative to hospital infections.