摘要
目的分析慢性肾衰竭合并肺部感染患者的病原菌分布状况以及耐药性。方法收集2022年1月至2023年1月漯河市第二人民医院收治的92例慢性肾衰竭合并肺部感染患者的痰液标本,剔除同一例患者相同部位的重复采集样本,获得最终病原菌样本。统计病原菌的种类、数量及对抗菌药物的敏感性,分析病原菌的分布情况及耐药性。结果92例患者痰液标本中共分离获得102株病原菌,其中革兰阴性菌最多,共63株,占比61.76%(63/102),主要为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌;其次为革兰阳性菌31株,占比30.39%(31/102);真菌8株,占比7.84%(8/102)。革兰阴性菌中,对肺炎克雷伯菌耐药前三位的药物依次为头孢唑林、链霉素以及环丙沙星;对大肠埃希菌耐药前三位的药物依次为环丙沙星、头孢唑林以及头孢曲松;对铜绿假单胞菌耐药前三位的药物依次为头孢曲松、环丙沙星、庆大霉素。革兰阳性菌中,对金黄色葡萄球菌耐药前三位的药物为青霉素、头孢呋辛、红霉素;对表皮葡萄球菌耐药前三位的药物为左氧氟沙星、庆大霉素、环丙沙星;对肠球菌耐药前三位的药物为青霉素、环丙沙星、左氧氟沙星。结论慢性肾衰竭合并肺部感染的主要病原菌为革兰阴性菌,以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌最常见,且不同病原菌对抗菌药物的耐药性存在一定差异,临床应根据患者耐药情况合理用药。
Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with chronic renal failure complicated by pulmonary infection.Methods The sputum samples were collected from 92 patients with chronic renal failure complicated by pulmonary infection who were treated in Luohe Second People’s Hospital from January 2022 to January 2023,duplicate samples from the same patient and site were eliminated,and the final pathogen samples were obtained.The type,quantity,and sensitivity to antibiotics of pathogenic bacteria were counted.The distribution and drug resistance of pathogenic bacteria were analyzed.Results A total of 102 strains of pathogenic bacteria were isolated from the sputum samples of the 92 patients,with Gram negative bacteria(63 strains)as the most common,accounting for 61.76%(63/102).Klebsiella pneumoniae,Escherichia coli,and Pseudomonas aeruginosa were the most widely distributed bacteria.Gram positive bacteria were the second common pathogen(31 strains),accounting for 30.39%(31/102).There were 8 strains of fungi,accounting for 7.84%(8/102).Among the Gram negative bacteria,Klebsiella pneumoniae were resistant to cefazolin,streptomycin and ciprofloxacin,the top three drugs;Escherichia coli was resistant to ciprofloxacin,cefazolin,and ceftriaxone,the top three drugs;Pseudomonas aeruginosa was resistant to ceftriaxone,ciprofloxacin,and gentamicin,the top three drugs.Among the Gram positive bacteria,Staphylococcus aureus was resistant to penicillin,cefuroxime,and erythromycin,the top three drugs;Staphylococcus epidermidis was resistant to levofloxacin,gentamicin,and ciprofloxacin,the top three drugs;Enterococcus was resistant to penicillin,ciprofloxacin and levofloxacin,the top three drugs.Conclusions The main pathogenic bacteria for chronic renal failure complicayed by pulmonary infection are Gram negative bacteria,with Klebsiella pneumoniae,Escherichia coli,and Pseudomonas aeruginosa as the most common.There are some differences in the resistance of different pathogens to antibiotics,and rational medication should be used according to the patient’s drug resistance in clinical practice.
作者
孙院红
阮国虎
孙红艳
Sun Yuanhong;Ruan Guohu;Sun Hongyan(Department of Clinical Laboratory,Luohe Second People’s Hospital,Luohe 462000,China;Intensive Care Unit,Luohe Second People’s Hospital,Luohe 462000,China)
出处
《中国实用医刊》
2023年第18期29-32,共4页
Chinese Journal of Practical Medicine
关键词
慢性肾衰竭
肺部感染
病原菌
耐药性
Kidney failure,chronic
Pulmonary infection
Pathogenic bacteria
Drug resistance
作者简介
通信作者:孙院红,Email:sun1974yuanhong@163.com。
