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[胸外科手术后支气管肺泡灌洗(BAL)液中的厌氧菌]

[Anaerobic bacteria in bronchoalveolar lavage fluid (BAL) after thoracic surgery].

作者信息

Zajac-Lenczewska Ina, Kedzia Anna, Skokowski Jan, Sternau Adam

出版信息

Med Dosw Mikrobiol. 2003;55(2):173-80.

Abstract

Purpose of this study was to find out what kind of anaerobic bacteria were in lower respiratory tract and how often they were present there considering patients after thoracic surgery. Also, what is susceptibility of bacteria to antibiotics. Research covered 30 patients after operation. Material for research was bronchoalveolar lavage (BAL) taken during bronchoscopy. Collected sample was cultivated in anaerobic and aerobic conditions. Anaerobic bacteria were found in 28 samples (93%). Totally there were 100 anaerobic bacteria strains. The most common Gram-negative rods were from genus Prevotella (24 strains, 24%) and Bacteroides (15 strains, 15%). Gram-negative bacteria except Bacteroides characterised biggest susceptibility to imipenem, piperacillin/tazobactam, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin, clindamycin and metronidazol. Bacteroides were susceptible to imipenem, piperacillin/tazobactam and metronidazol. Among Gram-positive anaerobic bacteria mostly were isolated from cocci Peptostreptococcus (18 strains, 18%) and were susceptible to all antibiotics. Gram-positive rods were in most cases represented by Actinomyces (12 strains 12%) and were highly susceptible to all antibacterial means except metronidazol (100% is resistant).

摘要

本研究的目的是了解胸外科手术后患者下呼吸道中存在何种厌氧菌以及其出现频率。此外,这些细菌对抗生素的敏感性如何。研究涵盖了30例术后患者。研究材料为支气管镜检查时采集的支气管肺泡灌洗(BAL)样本。采集的样本在厌氧和好氧条件下培养。在28个样本(93%)中发现了厌氧菌。总共分离出100株厌氧菌。最常见的革兰氏阴性杆菌是普雷沃菌属(24株,24%)和拟杆菌属(15株,15%)。除拟杆菌属外,革兰氏阴性菌对亚胺培南、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、氨苄西林/舒巴坦、哌拉西林、克林霉素和甲硝唑的敏感性最高。拟杆菌属对亚胺培南、哌拉西林/他唑巴坦和甲硝唑敏感。在革兰氏阳性厌氧菌中,大多分离自消化链球菌属球菌(18株,18%),且对所有抗生素敏感。革兰氏阳性杆菌在大多数情况下由放线菌属代表(12株,12%),除甲硝唑外(耐药率100%)对所有抗菌药物高度敏感。

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