[1]彭艳华,刘艳芝,伏 钢,等.尘肺病并发下呼吸道感染患者病原菌分布及耐药性分析[J].现代检验医学杂志,2023,38(04):196-200.[doi:10.3969/j.issn.1671-7414.2023.04.036]
　PENG Yanhua,LIU Yanzhi,FU Gang,et al.Distribution and Drug Resistance of Pathogenic Bacteria in Pneumoconiosis Patients with Lower Respiratory Tract Infection[J].Journal of Modern Laboratory Medicine,2023,38(04):196-200.[doi:10.3969/j.issn.1671-7414.2023.04.036]
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尘肺病并发下呼吸道感染患者病原菌分布及耐药性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
196-200
栏目:
检验与临床
出版日期:
2023-07-15

文章信息/Info

Title:
Distribution and Drug Resistance of Pathogenic Bacteria in Pneumoconiosis Patients with Lower Respiratory Tract Infection
文章编号:
1671-7414（2023）04-196-05
作者:
彭艳华; 刘艳芝; 伏 钢; 杨沙沙
（湖南省职业病防治院检验科，长沙410007 ）
Author(s):
PENG Yanhua;  LIU Yanzhi;  FU Gang;  YANG Shasha
（Department of Clinic Laboratory ，Hunan Prevention and Treatment Institute for Occupational Diseases，Changsha 410007,China）
关键词:
尘肺; 下呼吸道感染; 病原菌; 耐药性
分类号:
R135.2；R446.5
DOI:
10.3969/j.issn.1671-7414.2023.04.036
文献标志码:
A
摘要:
目的　了解尘肺并发下呼吸道感染患者的病原菌分布以及对常用抗生素的耐药情况。方法　收集2020 年4 月1日～ 2022 年12 月31 日湖南省职业病防治院尘肺病并疑似下呼吸道感染住院患者的下呼吸道标本，进行细菌鉴定及药敏实验，采用 WHONET 5.6 软件统计分析病原菌分布和药敏试验结果。结果　从17 468 例标本中检出病原菌1 366 株，检出率7.82%，主要以革兰氏阴性杆菌为主，占86.42%（1 180/1 366），其中排在前三位的是肺炎克雷伯菌（42.24%）、流感嗜血杆菌（20.86%）和铜绿假单胞菌（9.52%）；革兰氏阴性球菌检出率为7.47%（102/1 366），全部为卡他莫拉菌；革兰氏阳性球菌检出率6.15%（84/1 366），其中主要是肺炎链球菌（4.83%，66/1 366）。不同分期尘肺患者下呼吸道前三位的检出菌与总体情况类似。肺炎克雷伯菌、流感嗜血杆菌、铜绿假单胞菌及卡他莫拉菌对头孢菌素、头孢菌素及酶抑制剂合剂、喹诺酮类和碳青霉烯类药物的耐药率≤ 10.0%；没有检出耐利奈唑胺或万古霉素的肺炎链球菌，对青霉素的耐药率为3.03%，对红霉素及克林霉素的耐药率>90%。结论　湖南地区尘肺并发下呼吸道感染患者的病原菌以革兰氏阴性杆菌为主，对头孢菌素、头孢菌素及酶抑制剂合剂、喹诺酮类和碳氢霉烯类药物比较敏感；而检出革兰氏阳性球菌以肺炎链球菌为主，对青霉素、利奈唑胺或万古霉素很敏感；临床可根据患者具体情况选择相对应敏感的药物治疗。
Abstract:
Objective　To investigate the distribution of pathogenic bacteria in patients with pneumoconiosis complicated with lower respiratory tract infection and their resistance to common antibiotics. Methods　Lower respiratory tract samples of hospitalized patients with pneumoconiosis and suspected lower respiratory tract infection were collected from Hunan Prevention and Treatment Institute for Occupational Diseases from April 1, 2020 to December 31, 2022. Bacterial identification and drug sensitivity test were conducted. WHONET 5.6 software was used to analyze the distribution of pathogenic bacteria and drug sensitivity test results. Results　1 366 strains of pathogenic bacteria were detected from 17 468 samples, the detection rate was 7.82%，mainly Gram-negative bacillus, accounting for 86.42%（1 180/1 366）, among which the top three were Klebsiella pneumoniae（42.24%）, Haemophilus influenzae （20.86%）and Pseudomonas aeruginosa （9.52%）. The detection rate of Gram-negative cocci was 7.47%（102/1 366）, all of which were Moraxella catarra. The detection rate of Gram-positive cocci was 6.15%（84/1 366）, and the main one was Streptococcus pneumoniae（4.83%, 66/1 366）.The bacteria detected in the first three parts of the lower respiratory tract of patients with different stages of pneumoconiosis were similar to the general situation. The drug resistance rates of Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa and Moraxella catarrhal to cephalosporins, cephalosporins and enzyme inhibitor mixtures, quinolones and hydrocarbases were less than 10.0%. Streptococcus pneumoniae without linezolid or vancomycin resistance was 3.03% to penicillin and >90% to erythromycin and clindamycin. Conclusion　The pathogenic bacteria of pneumoconiosis patients with lower respiratory tract infection in Hunan area were mainly Gram-negative bacilli, which were sensitive to cephalosporin, cephalosporin and enzyme inhibitor mixture, quinolones and hydrocarbon-enzyme alkenes. The gram-positive coccus were mainly Streptococcus pneumoniae, which were sensitive to penicillin，linezolid or vancomycin. Clinical treatment can be selected according to the specific conditions of patients should be relatively sensitive drugs.

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备注/Memo

备注/Memo:
作者简介：彭艳华（1979-），女，硕士研究生，副主任技师，研究方向：临床检验, E-mail:32421693@qq.com。
更新日期/Last Update: 2023-07-15