Distribution And Drug Resistance Of Common Pathogens In Pneumoconiosis Combined With Pulmonary Infection

Objective Do different period, different types and classes of drug resistance of pathogens in lower respiratory tract infections in patients with pneumoconiosis for statistical analysis, to provide clinical evidence for clinicians early empiric antimicrobial therapy.Methods Choose since July 2011 to July 2014 in our hospital patients with pneumoconiosis 1752 cases, which merged with lower respiratory tract infections total 982 cases, including 271 cases of pulmonary infection silicosis,pneumoconiosis welders 253 cases of pulmonary infection, black 102 cases of pneumoconiosis pulmonary infection, pulmonary infection caster 95 cases of pneumoconiosis, coal workers’ pneumoconiosis pulmonary infection 88 cases, 72 cases of pulmonary infection cement pneumoconiosis, talc pneumoconiosis 56 cases of pulmonary infection, graphite pneumoconiosis merger pulmonary infection in 31 cases, 14 cases of asbestosis pulmonary infection.All male, aged37 to 85 years, mean(54.18 ± 7.43) years. Divided into four groups according to age, were more than 35 years old, 36-50 years old, 51-69 years old,and 70 years old. Under the 982 cases of patients with upper respiratory tract infection in 485 cases of stage I patients, aged 37 to 61 years, mean(52.4 ± 6.0) years old; II stage group 286 cases, aged 43 to 74 years, mean(56.2 ± 8.9) years; Phase III 211 cases of the group, aged 42 to 85 years, mean(56.1 ± 8.3) years.Depending on whether patients with chronic obstructive pulmonary disease, bronchiectasis, bronchial asthma pneumoconiosis patients will be divided into three groups: 61 patients with pneumoconiosis and chronic obstructive pulmonary disease group, age(53 to79) years, mean(61.3 ± 8.6) years old; pneumoconiosis bronchiectasis patients42 cases, age(37 to 65) years, mean(52.6± 6.2) years; pneumoconiosis patients35 cases of bronchial asthma, age(31-68) years, mean(50.2 ± 7.1) year old.According to dust seniority divided into four groups, each group for nine years or less, 10-19 years group, the 20-29 year group, greater than or equal to 30 years group.Diagnosis of pneumoconiosis is based on "pneumoconiosis diagnosticcriteria"(GBZ70-2009) collective diagnosis by Weihai pneumoconiosis diagnosis groups. Chronic obstructive pulmonary disease diagnosis is based on lung function tests showed inhaled bronchodilator FEV1 / FVC <70% of the diagnostic criteria; bronchiectasis diagnosis based on chest X-ray or CT scan lung radiographic findings are consistent with the diagnostic criteria for bronchiectasis;bronchial asthma diagnosis of bronchial asthma guidelines(GINA2014)diagnostic criteria; the incidence of lower respiratory tract infection is hospitalized after 48 h, the cough, sputum or mucus traits change, and meet one of the following criteria were as diagnostic criteria: 1 fever(temperature more than or equal 37.3), the lungs could be heard and crackles, or pneumoconiosis or chest CT slices compared with admission, showed a new inflammatory changes; 2.qualified pathogens cultured sputum samples; 3 laboratory examination of blood,procalcitonin, IL-6, C-reactive protein, erythrocyte sedimentation rate and other inflammatory markers were significantly increased. Collected sputum specimens for oral culture of bacteria detection applications Auto Scan 4 Microbial Identification System, a joint KB disk susceptibility testing method.Results1.Lower respiratory tract infections in patients with pneumoconiosis Gram-negative bacilli, including Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter spp among the top four.Gram-positive cocci distribution is relatively small, Staphylococcus aureus,Streptococcus pneumoniae based. G-bacilli to imipenem, meropenem, amikacin,aztreonam, cefoperazone / sulbactam and Cefepime is highly sensitive, but the third generation cephalosporin resistance is higher. G+cocci to vancomycin,teicoplanin highly sensitive to cephalosporins three generations, four generations of serious resistance.2. Research pneumoconiosis patients with different stages of other lower respiratory tract infections common pathogens classification.3. Research the different categories of pneumoconiosis common infecting pathogens classification.4. Research different complications pneumoconiosis patients with lower respiratory tract infection common pathogens classification.5. The other classification of pneumoconiosis patients with different,relatively lower respiratory tract infection numbers in each group, the difference was statistically significant(P <0.01).6.Classification of pneumoconiosis patients of different ages, comparing the combined number of infections of lower respiratory tract infections in each group,the difference was statistically significant(P <0.01).7.seniority to dust pneumoconiosis patients with different classification, lower respiratory tract infection merger compare the number of infections in each group,the difference was not statistically significant(P> 0.05).8.The classification of different types of pneumoconiosis, lower respiratory tract infection merger compare the number of infections in each group, the difference was statistically significant(P <0.01).Conclusion Gram-negative bacteria as the main pathogens of pneumoconiosis patients with lower respiratory tract infections, but resistance to commonly used antibiotics in severe circumstances, changes in bacterial resistance should strengthen the monitoring, so the rational use of antimicrobial drugs, improve patient survival quality.