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目的探讨结核性脑膜炎患者呼吸道感染的临床特点,为临床医师选择使用抗菌药物预防医院感染提供依据。方法分析138例结核性脑膜炎呼吸道感染患者的临床资料、病原菌分布及耐药特点,数据采用SPSS15.0统计软件进行处理。结果 138例患者痰液培养出病原菌92株,培养阳性率为66.67%,其中革兰阴性菌80株占86.96%,革兰阳性菌6株占6.52%,真菌6株占6.52%;革兰阴性菌中鲍氏不动杆菌检出33株最多,占35.87%,其次为铜绿假单胞菌17株占18.48%,肺炎克雷伯菌15株占16.30%,大肠埃希菌8株占8.70%;革兰阳性菌均为金黄色葡萄球菌;革兰阴性菌中鲍氏不动杆菌对常用抗菌药物普遍耐药,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对头孢哌酮/舒巴坦耐药率低,均<13.00%;金黄色葡萄球菌对万古霉素均敏感,对苯唑西林耐药率高;6株白色假丝酵母菌对氟康唑耐药率为32.00%,对两性霉素B敏感。结论结核性脑膜炎患者呼吸道感染病原菌以革兰阴性菌为主,病原菌对头孢哌酮/舒巴坦较为敏感,提示临床医师在治疗过程中对难治性感染可选用头孢哌酮/舒巴坦。
Objective To investigate the clinical features of respiratory tract infection in patients with tuberculous meningitis and provide evidence for clinicians to choose antibacterials to prevent nosocomial infections. Methods The clinical data, pathogen distribution and drug resistance of 138 patients with tuberculous meningitis respiratory tract infection were analyzed. The data were processed by SPSS15.0 statistical software. Results A total of 92 pathogenic bacteria were cultured in sputum of 138 patients. The positive rate of culture was 66.67%. Among them, 80 strains of Gram-negative bacteria accounted for 86.96%, 6 strains of Gram-positive bacteria accounted for 6.52% and 6 strains of fungi accounted for 6.52% Acinetobacter baumannii was detected in 33 strains, accounting for 35.87%, followed by 17 strains of Pseudomonas aeruginosa accounted for 18.48%, 15 strains of Klebsiella pneumoniae accounted for 16.30%, 8 strains of Escherichia coli accounted for 8.70% ; Gram-positive bacteria are Staphylococcus aureus; Gram-negative bacteria Acinetobacter baumannii commonly used antibacterial drugs generally resistant to Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli on cefoperazone / Sulbactam resistance rates were low, were <13.00%; Staphylococcus aureus were sensitive to vancomycin, oxacillin resistance rate was high; 6 Candida albicans resistance to fluconazole was 32.00 %, Sensitive to amphotericin B. Conclusions The main pathogens of respiratory infection in patients with tuberculous meningitis are Gram-negative bacteria, and the pathogens are more sensitive to cefoperazone / sulbactam, suggesting that clinicians should choose cefoperazone / sulbactam for refractory infection during treatment .