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目的调查肺结核合并下呼吸道大肠埃希菌感染患者的临床特点及其病原菌对常用抗菌药物的耐药性,为临床诊疗提供参考依据。方法回顾性分析2011年1月至2015年8月共109例肺结核患者合并下呼吸道感染病例,按照《全国临床检验操作规程》第3版操作流程分离鉴定,K-B纸片扩散法进行药敏试验。结果检出大肠埃希菌的标本主要为痰液(88.07%)。药敏检测提示,大肠埃希菌对阿米卡星、亚胺培南、哌拉西林/他唑巴坦、美罗培南、奈替米星、妥布霉素和头孢哌酮/舒巴坦较敏感,耐药率均<20%,可作为临床治疗该菌感染的首选抗菌药物。结论大肠埃希菌是导致肺结核患者下呼吸道感染常见致病菌之一,其耐药性较高,应引起人们的高度关注。同时应提高临床样本的送检率,根据药敏检测结果合理选用抗菌药物。
Objective To investigate the clinical features of pulmonary tuberculosis patients with lower respiratory tract Escherichia coli infection and its resistance to commonly used antimicrobial agents and to provide a reference for clinical diagnosis and treatment. Methods A total of 109 cases of pulmonary tuberculosis complicated with lower respiratory tract infection were retrospectively analyzed from January 2011 to August 2015. The samples were separated and identified according to the operational procedures of the 3rd edition of the National Clinical Laboratory Procedures and the drug susceptibility test was performed with K-B disk diffusion method. Results The samples of Escherichia coli were mainly sputum (88.07%). Drug susceptibility tests suggest that the Escherichia coli to amikacin, imipenem, piperacillin / tazobactam, meropenem, netilmicin, tobramycin and cefoperazone / sulbactam than Sensitive, resistance rate was <20%, can be used as clinical treatment of bacterial infections preferred antibacterial drugs. Conclusion Escherichia coli is one of the common pathogenic bacteria causing lower respiratory tract infection in patients with pulmonary tuberculosis. Its high drug resistance should attract people’s attention. At the same time, the rate of submission of clinical samples should be increased, and antibiotics should be selected reasonably based on the results of drug susceptibility testing.