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目的探讨肺结核患者院内获得性肺炎病原菌分布和耐药性,为临床治疗院内获得性肺炎提供用药指导。方法对46例肺结核患者院内获得性肺炎58株病原菌资料进行回顾性分析。结果58株病原菌中,革兰阴性杆菌35株,占60.3%,其中铜绿假单胞菌17株,革兰阳性球菌15株,占25.9%,以金黄色葡萄球菌为主,真菌8株,占13.8%。常用抗菌素耐药率由高到低分别为头孢呋辛82.7%,头孢哌酮79.3%、头孢曲松69%、氧氟沙星51.7%、哌拉西林48.3%等,最高为头孢呋辛,最低为亚胺培南17.2%。同时耐两种以上抗菌素者28株占48.3%。结论肺结核患者院内获得性肺炎的主要病原菌为革兰阴性杆菌,对头孢呋辛的耐药率最高,对亚胺培南的敏感性最高,有的病原菌同时耐多种抗菌素。
Objective To investigate the distribution and drug resistance of pathogenic bacteria of nosocomial pneumonia in patients with pulmonary tuberculosis and to provide guidance for the clinical treatment of nosocomial pneumonia. Methods The data of 58 pathogenic bacteria of nosocomial pneumonia in 46 patients with pulmonary tuberculosis were retrospectively analyzed. Results Among 58 pathogens, 35 strains of Gram-negative bacilli accounted for 60.3%, of which 17 strains were Pseudomonas aeruginosa and 15 strains were Gram-positive cocci, accounting for 25.9%. Staphylococcus aureus was the main strain and 8 strains were fungi 13.8%. The antibiotic resistance rates of common antibiotics were cefuroxime 82.7%, cefoperazone 79.3%, ceftriaxone 69%, ofloxacin 51.7% and piperacillin 48.3%, the highest was cefuroxime, the lowest Imipenem 17.2%. At the same time resistant to two or more antibiotics 28 strains accounted for 48.3%. Conclusions The main pathogens of nosocomial pneumonia in patients with pulmonary tuberculosis are Gram-negative bacilli, the highest resistance rate to cefuroxime, the highest sensitivity to imipenem, and some pathogens are resistant to many antibiotics at the same time.