矽肺患者院内肺部感染病原菌及耐药性分析

目的]观察矽肺患者院内肺部感染的病原菌及其耐药性，为治疗提供借鉴。方法]选择2000年1月至2004年12月上海交通大学附属新华医院院内肺部感染患者114例作为研究对象，分为矽肺患者74例（S组）和非矽肺患者40例（NS组）两组，比较两组痰培养及抗生素药敏的情况。结果]两组患者院内肺部感染的病原菌均以G-杆菌为主，分别占61．22％和65．22％，且均以铜绿假单胞菌、肺炎克雷伯菌为主；两组病原菌对多种抗生素耐药率均较高，S组的耐药率高于NS组，S组G-杆菌对头孢唑啉、头孢他啶、环丙沙星的耐药性高于NS组（P〈0．05）；S组治疗好转率低于NS组。结论]矽肺患者院内肺部感染以G-杆菌为主，细菌耐药性较高，建议临床医师根据痰培养及药敏结果，正确合理地选用抗菌药物。

Analysis of Pathogens Isolated from Nosocomial Pulmonary Infection in Silicosis Patients

Objective To study the pathogens isolated from nosocomial pulmonary infection in silicosis patients and the drug-resistance of these pathogens for providing reference of treatment. Methods 114 patients with nosocomial infection were chosen in the ward during the period of Jan. 2000 to Dec. 2004,in which 74 were silicotic patients(S group),40 were non silicotic patients(NS group). Sputum culture and drug susceptibility were compared in the two groups. Results It showed that Gram negative bacilli were the predominant pathogens in both groups,they counted as 61.22% and 65.22%, respectively. The main organisms were Pseudomonas aeruginosa and Klebsiella species. The pathogens found in the two groups had higher frequency of drug resistance to multiple antibiotics,and showed higher resistant in S group than in NS group. Higher resistance to cefazoline,cefotaxime and ceftazidime was found in Gram negative bacteria cultured from S group than that from NS group(P < 0.05). The improvement rate after treatment in S group was lower than that in NS group. Conclusions The results indicate Gram negative bacilli are the predominant pathogens in nosocomial pulmonary infection in silicosis patients and their drug resistance to antibiotics raised markedly. Doctors should choose antibiotics reasonably according to the sputum culture and drug resistance result.