肺结核患者继发呼吸道细菌感染的病原菌及其耐药性分析

目的了解肺结核患者继发呼吸道感染的病原菌及其对常用抗菌药物的敏感性。方法病原菌的鉴定应用API系统，药敏试验应用K—B纸片扩散法。结果革兰氏阴性杆菌已经成为肺结核病人呼吸道感染最常见的病原菌，其中以肺炎克雷白杆菌、铜绿假单胞菌、大肠埃希菌为主，革兰阳性菌以金葡菌为主；三代头孢菌素对大部分革兰氏阴性杆菌保持较好的抗菌活性。肺结核患者继发呼吸道感染的病原菌对抗菌药物的耐药率普遍高于一般呼吸道感染病人。结论肺结核合并感染的患者中，应选用对革兰氏阴性杆菌效果较好的药物，并尽可能根据药敏试验选药，以避免不合理应用抗菌药物导致细菌耐药的产生。

Analysis of the pathogens causing respiratory tract infection and their drug resistance in patients with lung tuberculosis

Objective To investigate the pathogens causing respiratory tract infection and its sensitivity to antibacterials in patients with lung tuberculosis. Methods The API method was used to identify pathogens and K-B test was used to study the antibacterial sensitivity. Results G-negative bacilli was major pathogens causing respiratory tract infection in patients with lung tuberculosis, in which K.lebsiella,P.aeugnosa and E.coli were predominant. S.aureus was predominant in G-positive cocci.The major G-negative bacilli were sensitive to the third generation cephalosporin. The rate of drug-resistance for pathogens causing respiratory tract infection in patients with lung tuberculosis was higher than that of non-respiratory tract infection patients.Conclusions Some antibacterials which has good effects on G-negative bacilli should be used to patients with tuberculosis concurrent respiratory tract infection. The use of antibacterials should follow the result of K-B test.