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本文引用的文献

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BTS guidelines for the management of community acquired pneumonia in adults: update 2009.英国胸科学会成人社区获得性肺炎管理指南:2009年更新版
Thorax. 2009 Oct;64 Suppl 3:iii1-55. doi: 10.1136/thx.2009.121434.
2
Acute lower respiratory tract infection.急性下呼吸道感染
N Engl J Med. 2008 Feb 14;358(7):716-27. doi: 10.1056/NEJMra074111.
3
Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults.美国感染病学会/美国胸科学会关于成人社区获得性肺炎管理的共识指南。
Clin Infect Dis. 2007 Mar 1;44 Suppl 2(Suppl 2):S27-72. doi: 10.1086/511159.
4
A view on antimicrobial resistance in developing countries and responsible risk factors.关于发展中国家的抗菌药物耐药性及相关风险因素的观点
Int J Antimicrob Agents. 2004 Aug;24(2):105-10. doi: 10.1016/j.ijantimicag.2004.02.015.
5
Excess mortality associated with antimicrobial drug-resistant Salmonella typhimurium.与耐抗菌药物鼠伤寒沙门氏菌相关的超额死亡率。
Emerg Infect Dis. 2002 May;8(5):490-5. doi: 10.3201/eid0805.010267.
6
Morbidity of infections caused by antimicrobial-resistant bacteria.由抗菌药物耐药菌引起的感染的发病率。
Clin Infect Dis. 2002 Jun 1;34 Suppl 3:S131-4. doi: 10.1086/340251.

痰标本的细菌学分析:一家三级医院的描述性横断面研究。

Bacteriology of Sputum Samples: A Descriptive Cross-sectional Study in a Tertiary Care Hospital.

机构信息

Department of Microbiology, KIST Medical College and Teaching Hospital, Gwarko, Lalitpur.

出版信息

JNMA J Nepal Med Assoc. 2020 Jan;58(221):24-28. doi: 10.31729/jnma.4807.

DOI:10.31729/jnma.4807
PMID:32335635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7580478/
Abstract

INTRODUCTION

Lower respiratory tract infection is a common infection and accounts for a greater burden of disease worldwide. It is a great challenge to the clinician and still more, with increasing antimicrobial resistance. Its empirical treatment may vary according to the type of causative organisms. The objective of this study is to identify the pathogenic microorganisms and their antimicrobial susceptibility pattern from sputum sample.

METHODS

This descriptive cross-sectional study was conducted in KIST Medical College and Teaching Hospital from February 2015 to January 2016. Ethical approval was taken from institutional review committee prior to the study with reference no. 0051/2014/15. Data on culture and sensitivity of isolates from sputum samples were collected from the records of the hospital. Sample collection, processing, identification of microorganisms and antimicrobial susceptibility tests were performed according to the Clinical and Laboratory Standards Institute guidelines. All the data were tabulated in an Excel sheet and analyzed using SPSS version 20.

RESULTS

Out of 2318 samples, 694 (29.93%) sputum samples at 95% confidence interval (737.21- 650.79) were reported as culture positive. Klebsiella was the most common isolate followed by Pseudomonas, Escherichia coli, Acinetobacter, Staphylococcus aureus, Candida albicans, Streptococcus pneumoniae, Streptococcus pyogenes, and others. Imipenem and vancomycin showed the most sensitivity towards gram-negative and gram-positive bacteria respectively.

CONCLUSIONS

Proper diagnosis, identification of causative agents and their antimicrobial susceptibility pattern are important steps to limit the irrational use of antimicrobials. Prescribing antimicrobials empirically in the case of suspected lower respiratory tract infection is difficult.

摘要

引言

下呼吸道感染是一种常见的感染,在全球范围内造成了更大的疾病负担。对于临床医生来说,这是一个巨大的挑战,尤其是在抗菌药物耐药性不断增加的情况下。其经验性治疗可能因致病微生物的类型而异。本研究的目的是从痰标本中确定致病微生物及其抗菌药物敏感性模式。

方法

本研究为 2015 年 2 月至 2016 年 1 月在 KIST 医学院和教学医院进行的描述性横断面研究。在进行这项研究之前,我们已经从机构审查委员会获得了伦理批准,参考号为 0051/2014/15。从医院记录中收集了痰标本的培养和药敏数据。根据临床和实验室标准协会的指南,对痰样本中的分离物进行样本采集、处理、微生物鉴定和抗菌药物敏感性试验。所有数据均在 Excel 表格中进行制表,并使用 SPSS 版本 20 进行分析。

结果

在 2318 个样本中,有 694 个(95%置信区间为 737.21-650.79)的痰样本培养呈阳性。在培养阳性的样本中,最常见的分离菌是肺炎克雷伯菌,其次是铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌、金黄色葡萄球菌、白色念珠菌、肺炎链球菌、化脓性链球菌和其他菌。亚胺培南和万古霉素对革兰氏阴性和革兰氏阳性细菌的敏感性最高。

结论

正确的诊断、确定病原体及其抗菌药物敏感性模式是限制不合理使用抗菌药物的重要步骤。在疑似下呼吸道感染的情况下,经验性使用抗菌药物是困难的。