结核病房医院感染与抗生素使用相关性分析

目的：探讨临床抗菌药物应用与结核病房医院感染严重程度的相关性。方法：分析3年来我院结核病房医院感染209例共计221株病原菌，细菌鉴定采用法国梅里埃ATB细菌鉴定药敏分析仪，药敏试验联合应用微量测定法与K—B纸片法。结果：在221株病原菌中革兰阴性杆菌最多为112株，占50．7％，念珠菌75株，占33．9％。主要致病菌依次为白色念珠菌61株(27．6％)，铜绿假单胞菌37株(16．8％)，肺炎克雷伯菌25株(10．9％)。药敏试验表明细菌耐药明显增加，大多数革兰阴性杆菌对亚胺培南、阿米卡垦、头孢他啶较敏感，金黄色葡萄球菌对万古霉素100％敏感。每例结核病患者除抗结核药物外平均使用2．67种抗菌药物。结论：结核病房医院感染主要来源于内源性感染，其严重性与抗菌药物大量、重复使用密切相关。

ANALYSING THE RELATIONSHIP BETWEEN HOSPITAL ACQUIRED INFECTIONS IN THE DEPARTMENT OF TUBERCULOSIS AND ANTIBIOTICS USING

Objective:To evaluate the mutual relationship of clinically used antibiotics and hospital acquired infections in tuberculosis Methods:To investigate the morbidity of hospital infections through laboratory diagnosis in our department of tuberculosis There were 209 cases in last three years ATB BioMerieux bacteria identification and drug sensitivity analyzer was adopted and through using Kirby Bauer disk sensitivity method reassured drug sensitivity Results:Among 221 strains of pathogens,Gram negative bacilli were 112(50 7%),fungus were 75(33 9%) The predominant pathogens were Candida albicans (61 strains,27 6%), Pseudomonus aeruginosa (37strains,16 8%), Klebsiella pneumoniae (24 strains,10 9%) Drug sensitivity showed that resistant becteria were markedly increasing but most bacteria were sensitive to imipenem,amikacin and ceftazidime Every cases were using 2 67 kinds of antibiotics averagely Conclusion:The study confirmed that hospital acquired infections in tuberculosis patients was mainly come from endogenous infection,that is significantly correlated with massive and repeated use of antibiotics