中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2015年
2期
129-131
,共3页
尘肺%肺炎%病原菌%抗药性
塵肺%肺炎%病原菌%抗藥性
진폐%폐염%병원균%항약성
Pneumoconiosis%Pneumonia%Pathogen%Drug resistance
目的 探讨煤工尘肺合并肺炎的病原菌分布及耐药性,为早期指导临床合理使用抗菌药物提供科学依据.方法 选择宁波市第一医院呼吸科和宁波市第二医院肺科201 1年6月至2014年6月期间收治的76例煤工尘肺合并肺炎患者为研究对象,无菌收集痰标本进行细菌培养,并进行药敏试验.结果 76例患者送检痰标本245例次,经细菌学检验共分离出218株病原菌,其中革兰阴性杆菌(G-)163株,占74.77％;革兰阳性球菌(G+)39株,占17.89％;真菌16株,占7.34％.主要革兰阴性杆菌对阿莫西林/克拉维酸、氨苄西林、复方磺胺甲唑、头孢噻肟、氨曲南等耐药率高,对阿米卡星、亚胺培南、美罗培南敏感;主要革兰阳性球菌对青霉素、红霉素、阿莫西林/克拉维酸、氨苄西林、头孢噻肟、克林霉素等耐药率高,对万古霉素、替考拉宁敏感.结论 该组煤工尘肺合并肺炎病例的主要病原菌为革兰阴性杆菌,临床上常用的抗菌药物多有严重的耐药性,应掌握好病原菌的分布及其耐药性,根据药敏试验结果合理选择抗菌药物.
目的 探討煤工塵肺閤併肺炎的病原菌分佈及耐藥性,為早期指導臨床閤理使用抗菌藥物提供科學依據.方法 選擇寧波市第一醫院呼吸科和寧波市第二醫院肺科201 1年6月至2014年6月期間收治的76例煤工塵肺閤併肺炎患者為研究對象,無菌收集痰標本進行細菌培養,併進行藥敏試驗.結果 76例患者送檢痰標本245例次,經細菌學檢驗共分離齣218株病原菌,其中革蘭陰性桿菌(G-)163株,佔74.77％;革蘭暘性毬菌(G+)39株,佔17.89％;真菌16株,佔7.34％.主要革蘭陰性桿菌對阿莫西林/剋拉維痠、氨芐西林、複方磺胺甲唑、頭孢噻肟、氨麯南等耐藥率高,對阿米卡星、亞胺培南、美囉培南敏感;主要革蘭暘性毬菌對青黴素、紅黴素、阿莫西林/剋拉維痠、氨芐西林、頭孢噻肟、剋林黴素等耐藥率高,對萬古黴素、替攷拉寧敏感.結論 該組煤工塵肺閤併肺炎病例的主要病原菌為革蘭陰性桿菌,臨床上常用的抗菌藥物多有嚴重的耐藥性,應掌握好病原菌的分佈及其耐藥性,根據藥敏試驗結果閤理選擇抗菌藥物.
목적 탐토매공진폐합병폐염적병원균분포급내약성,위조기지도림상합리사용항균약물제공과학의거.방법 선택저파시제일의원호흡과화저파시제이의원폐과201 1년6월지2014년6월기간수치적76례매공진폐합병폐염환자위연구대상,무균수집담표본진행세균배양,병진행약민시험.결과 76례환자송검담표본245례차,경세균학검험공분리출218주병원균,기중혁란음성간균(G-)163주,점74.77％;혁란양성구균(G+)39주,점17.89％;진균16주,점7.34％.주요혁란음성간균대아막서림/극랍유산、안변서림、복방광알갑서、두포새우、안곡남등내약솔고,대아미잡성、아알배남、미라배남민감;주요혁란양성구균대청매소、홍매소、아막서림/극랍유산、안변서림、두포새우、극림매소등내약솔고,대만고매소、체고랍저민감.결론 해조매공진폐합병폐염병례적주요병원균위혁란음성간균,림상상상용적항균약물다유엄중적내약성,응장악호병원균적분포급기내약성,근거약민시험결과합리선택항균약물.
Objective To investigate the pathogen distribution and drug resistance in coal workers' pneumoconiosis associated with pneumonia and to provide a scientific basis for early guidance for rational clinical application of antibacterial agents.Methods Seventy-six patients with coal workers' pneumoconiosis associated with pneumonia who were admitted to our hospital from June 2011 to June 2014 were enrolled as subjects.The sputum specimens were aseptically collected for bacterial culture and drug sensitivity tests.Results In 245 sputum specimens collected from 76 patients,a total of 218 strains of pathogens,including 163 strains of Gram-negative bacilli (74.77％),39 strains of Gram-positive cocci (17.89％),and 16 strains of fungi (7.34％) were isolated by bacteriological tests.The main Gram-negative bacilli had high rates of resistance to amoxicillin/clavulanic acid,ampicillin,cotrimoxazole,cefotaxime,and aztreonam,and were sensitive to amikacin,imipenem,and meropenem.The main Gram-positive cocci had high rates of resistance to penicillin,erythromycin,amoxicillin/clavulanic acid,ampicillin,cefotaxime,and clindamycin,and were sensitive to vancomycin and teicoplanin.Conclusion The main pathogens in these patients with coal workers' pneumoconiosis associated with pneumonia are Gram-negative bacilli,which are highly resistant to common clinically used antibacterial agents.The pathogen distribution and drug resistance should be well understood,and the antibacterial agents should be rationally selected according to the results of drug sensitivity tests.
