肺结核与非结核患者罹患下呼吸道感染的细菌分布及耐药性比较

Distribution and Drug Resistance of Bacteria Causing Lower Respiratory Tract Infections Between Tuberculosis and No-tuberculosis Patients

关键词:  肺结核病  呼吸系统  下呼吸道感染  细菌

Key words:  tuberculosis  the respiratory system  lower respiratory tract infection  bacteria

摘要:

目的 探讨结核科与呼吸科下呼吸道感染的病原菌分布及耐药率差别，为临床医师合理应用抗菌药物提供依据。方法 收集2013年7月-2014年7月结核科与呼吸科患者送检的痰液及灌洗液标本，采用VIT EK-32全自动微生物鉴定系统对病原菌进行鉴定及药敏试验，并用SPSS 17.0软件进行数据分析。结果 结核科与呼吸科的病原菌构成以及耐药率有一定的差异。肺炎克雷伯菌、铜绿假单胞菌、产酸克雷伯菌在结核科和呼吸科细菌分布上存在统计学差异（P分别为0.002，0.000，0.044）；肺炎克雷伯菌在结核科和呼吸科对常用抗菌药物的耐药率相似；铜绿假单胞菌在呼吸科的耐药率高于结核科；鲍曼不动杆菌在呼吸科的耐药率明显高于结核科；甲氧西林敏感金黄色葡萄球菌在结核科和呼吸科对常用抗菌药物的耐药率相似，未出现耐甲氧西林金黄色葡萄球菌。结论 肺结核患者与非结核患者罹患下呼吸道感染的细菌分布及耐药性均有所不同，临床医师应掌握本科室病原菌分布及耐药率情况，才能正确合理应用抗菌药物。

Abstract:

OBJECTIVE To explore the distribution and drug resistance rates of pathogens causing lower respiratory tract infections in tuberculosis and respiratory department so as to provide basis for the rational clinical application of antibiotics. METHODS The sputum specimens and lavage specimens that were submitted form tuberculosis and respiratory department during July 2013 to July 2014 were collected. The bacterial identification and drug susceptibility testing were performed by VIT EK-2 Compact automatic bacteria identification system. The data were analyzed by means of SPSS 17.0 software. RESULTS The pathogens distribution and drug resistance ratios of tuberculosis and respiratory department were different. Statistical differences in bacteria distribution of Klebsiella pneumoniae, Pseudomonas aeruginosa, Klebsiella acid bacteria were observed between tuberculosis and respiratory. Drug resistance rates of K. pneumonia were similar in tuberculosis and respiratory department. The rate of P. aeruginosa in respiratory department were significantly higher than those in tuberculosis department. The drug resistance rate of A.baumannii was higher in respiratory department than tuberculosis department. Drug resistance rates of methicillin-sensitive Staphylococcus aureus were similar in tuberculosis and respiratory department, with no methicillin-resistant Staphylococcus aureus. CONCLUSION The pathogens isolated from tuberculosis and no-tuberculosis patients in the distribution and drug resistance. It is necessary for cila physicians to grasp the distribution and drug resistance of the pathogens of own department in order to use antibiotics correctly.