肾综合征出血热少尿期的肺部感染菌群分布及其耐药分析

目的了解肾综合征出血热少尿期的肺部细菌感染对临床治疗的意义。方法送检的所有痰液标本按常规方法进行细菌分离鉴定,药敏试验为K-B法,ESBLs以双纸片协同试验进行,MRS检测为纸片筛选法。结果痰液标本338份,细菌培养检出率68.9%,革兰阴性菌占优势,以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌为主。对碳青霉烯类、头孢哌酮/他唑巴坦均分别低于9.09%、12.5%,头孢吡肟为27.4%,其余抗生素的耐药率均高于31.3%。3种主要产ESBLs菌对碳青霉烯类、头孢哌酮/他唑巴坦均分别低于15.8%、17.2%,其余抗生素的耐药率均高于55.2%。革兰阳性菌主要以金黄色萄葡球菌为主。结论肺部感染以革兰阴性菌占优势,碳青霉烯类、头孢哌酮/他唑巴坦是抗感染治疗的首选药物。

Pathogen distribution and their antibiotic resistance in HPRS patients of the oliguricstage with pulmonary infection: an analysis

Objective To investigate pulmonary infectious pathogens in HFRS patients of the olieuric stage and provide references for clinical treatment.Methods All the sputum samples isolated were identified with routine methods.Drug sensitivity tests were performed by K-B,ESBLs,double-disk synergy tests and MRR tests used disk sifttests.Results 233 strains of pathogens which were isolated from 338 sputum samples,with a positive rate of 68.9%.The most frequently isolated pathogens were gram negative bacilli,in which Pseudomonas aeruginosa,E.colli and Klebsiella were the main strains.The rates of drug resistance of gram negative bacilli to carbapenems and cefoperazone/tazobactam were lower than 9.09% and 12.5% respectively.To cefepine was 27.4%;to the rest of antibiotics were higher than 31.3%.The resistance rates of three kinds of pathogens which produce ESBLs to carbapenems and cefoperazone/tazobactam were lower than 15.8% and 17.2% respectively;to the rest of antibiotics were higher than 55.2%.In gram positive bacilli,Staphylococcus aureus made up the most.Conclusions The results suggest that dominant pathogens were gram negative bacilli in pulmonary infection.Carbapenems and cefoperazone/ tazobactam can be used as a preferred medicine curing the disease infected by the pathogens.