[1]江海燕,杨 敏,江 雪,等.结核性胸膜炎合并肺部感染病原菌特点、耐药性及影响因素分析[J].陕西医学杂志,2023,52(12):1740-1743,1748.[doi:DOI:10.3969/j.issn.1000-7377.2023.12.025]
　JIANG Haiyan,YANG Min,JIANG Xue,et al.Characteristics,drug resistance and influencing factors of pathogenic bacteria in tuberculous pleuritis complated with pulmonary infection[J].,2023,52(12):1740-1743,1748.[doi:DOI:10.3969/j.issn.1000-7377.2023.12.025]
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结核性胸膜炎合并肺部感染病原菌特点、耐药性及影响因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年12期
页码:
1740-1743,1748
栏目:
临床检验
出版日期:
2023-12-05

文章信息/Info

Title:
Characteristics,drug resistance and influencing factors of pathogenic bacteria in tuberculous pleuritis complated with pulmonary infection
作者:
江海燕1; 杨 敏1; 江 雪2; 邓 强1; 颜 璐1
(1.广安市人民医院检验科,四川 广安 638000; 2.广安市人民医院急诊科,四川 广安 638000)
Author(s):
JIANG Haiyan; YANG Min; JIANG Xue; DENG Qiang; YAN Lu
(Department of Laboratory,Guang'an People's Hospital,Guang'an 638000,China)
关键词:
结核性胸膜炎;  肺部感染;  革兰阳性菌;  革兰阴性菌;  耐药性;  影响因素
Keywords:
Tuberculous pleuritis;  Pulmonary infection;  Gram-positive bacteria;  Gram-negative bacteria;  Drug resistance;  Influencing factor
分类号:
R 521.7
DOI:
DOI:10.3969/j.issn.1000-7377.2023.12.025
文献标志码:
A
摘要:
目的:探究结核性胸膜炎合并肺部感染病原菌特点、耐药性及影响因素。方法:选取结核性胸膜炎疑似肺部感染患者200例为研究对象,以痰液培养结果分为感染组(132例)和未感染组(68例)。采集肺部感染者痰液标本并进行药敏试验,分析病原菌分布及其耐药性。收集患者临床资料,分析影响肺部感染发生的危险因素。结果:103例结核性胸膜炎合并肺部感染患者的痰液中共分离出138株病原菌,其中革兰阴性菌88株(63.77%),革兰阳性菌42株(30.43%),真菌8株(5.80%)。革兰阴性菌对氨苄西林(93.18%)、左氧氟沙星(59.09%)、磺胺甲恶唑(50.00%)等耐药率较高; 革兰阳性菌对青霉素(90.48%)、红霉素(66.67%)、利福平(50.00%)耐药率较高; 真菌对酮康唑(100.00%)、氟康唑(87.50%)、伏立康唑(62.50%)耐药率较高。在革兰阴性菌的抗生素中,与氨苄西林比较,其他抗生素的耐药率较低(均P<0.05)。在革兰阳性菌的抗生素中,与青霉素比较,其他抗生素的耐药率较低(均P<0.05)。在真菌的抗生素中,与酮康唑比较,仅有两性霉素B耐药性较低(P<0.05)。Logistic回归性分析结果显示,年龄>60岁、合并糖尿病、侵入性操作、长期使用糖皮质激素和广谱抗生素为结核性胸膜炎合并肺部感染发生的独立危险因素(均P<0.05)。结论:结核性胸膜炎合并肺部感染病原菌主要以革兰阴性菌为主,且对多种药物产生耐药性。年龄>60岁、合并糖尿病、侵入性操作、长期使用糖皮质激素和广谱抗生素均为肺部感染发生的危险因素。
Abstract:
Objective:To explore the characteristics,drug resistance and influencing factors of pathogenic bacteria in tuberculous pleuritis complated with pulmonary infection.Methods:A total of 200 tuberculous pleuritis patients with suspected pulmonary infection were selected as research subjects.According to the results of sputum culture,they were divided into infection group(132 cases)and non-infection group(68 cases).Sputum samples were collected from patients with pulmonary infection and drug sensitivity test was performed to analyze the distribution and drug resistance of pathogens.The clinical data of the patients were collected,and the risk factors affecting the occurrence of pulmonary infection were analyzed.Results:A total of 138 pathogenic bacteria were isolated from the sputum of 103 patients with tuberculous pleuritis complicated with pulmonary infection,including 88 Gram-negative bacteria(63.77%),42 Gram-positive bacteria(30.43%),and 8 fungi(5.80%).Gram-negative bacteria had high resistance rates to ampicillin(93.18%),levofloxacin(59.09%),and sulfamethoxazole(50.00%).Gram-positive bacteria had high resistance rates to penicillin(90.48%),erythromycin(66.67%)and rifampicin(50.00%).Fungi had high resistance rates to ketoconazole(100.00%),fluconazole(87.50%)and voriconazole(62.50%).Among the antibiotics for Gram-negative bacteria,compared with ampicillin,other antimicrobial resistance were lower(all P<0.05).Among the antibiotics for Gram-positive bacteria,the resistance rates of other antibiotics were lower than those of penicillin(all P<0.05).Among the antibiotics for fungi,compared with ketoconazole,the drug resistance of amphotericin B was significantly lower(P<0.05).Conclusion:Gram-negative bacteria are the main pathogens of tuberculous pleuritis complicated with pulmonary infection,and they are resistant to many drugs.Age >60 years,diabetes mellitus,invasive operation,long-term use of glucocorticoids and broad-spectrum antibiotics are risk factors for pulmonary infection.

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备注/Memo

备注/Memo:
基金项目:四川省卫生和计划生育委员会科研课题(17PJ090)
更新日期/Last Update: 2023-12-05