Comparison Of Pathogens Category And Drug Resistance Of Initial Treatment And Repeated Treatment In Pulmonary Tuberculosis Complicated With Pulmonary Infection

Background and Objective:It was reported by world health organization(WHO) that one third of world population had been infected by tubercule bacillus; There were over 8,700,000 new cases of tuberculosis and about 2,000,000 cases died of tuberculosis annually; Majority of dead cases were suffered from pulmonary tuberculosis. The most common complication of pulmonary tuberculosis is pulmonary infection which is also the major death factor of severe pulmonary tuberculosis. An effective method to prevent or treat pulmonary infection is a problem demanding a prompt solution in pulmonary tuberculosis cases. Several reports about pathogens category and drug resistance in pulmonary tuberculosis complicated with pulmonary infection is available in recent years, but there is few report about the comparison of initial treatment and repeated treatment cases. Based on this point, a clinical analysis of cases in pulmonary tuberculosis complicated with pulmonary infection from 2006 to 2009 in our hospital was presented, the comparison of pathogen category and drug resistance of initial treatment and repeated treatment was studied. Material and Method:Participant:All cases were active pulmonary tuberculosis regardless of the age, sex, weight and smoking. One group of 126 cases of initial treatment and another group of 200 cases of repeated treatment were all from Tian Tai People's hospital.Method:An opened clinical study was conducted. Sputum specimens for bacteria and fungi culture from all cases were collected in the early morning of the following two days of hospital visit or hospitalization. The result of culture was studied.Data Process:Analyzed by SPSS11.0 statistics software, measurement data and digital data were analyzed with T-test and x2 test respectively.Result:The gram-negative bacilli were the main pathogens of infection in this two groups and accounted for 52.52%,57.74% in initial treatment group and repeated treatment group respectively. The detection rate of fungi accounted for 18.71%,23.85% in initial treatment group and repeated treatment group respectively. The detection rate of the gram-negative bacilli and fungi in repeated treatment group raised but had no statistical difference. There was statistically significant difference that the gram-positive cocci were accounted for 28.78%,18.41% in initial treatment group and repeated treatment group respectively. Compared to the initial treatment group, the detection rate of the Streptococcus pneumoniae was decreased while Candida albicans was raised in repeated treatment group. The rate of drug resistance was also different in two groups. Compared to the initial treatment group, the rate of drug resistance of pathogens to rifampin, levofloxacin, moxifloxacin was extremely significantly raised and the rate of drug resistance of gram-negative bacilli to amikacin, third and fourth generation cephalosporin was significantly raised. The rate of Klebsiella pneumonia and Escherichia coli producing ESBLs strains was also increased. Conclusion:1. Pathogens in pulmonary tuberculosis complicated with pulmonary infection have changed to some extent as a result of repeated anti-tuberculosis therapy.2. The rate of antibiotic resistance has increased as a result of repeated anti-tuberculosis therapy.3. Pathogens producing ESBLs strains have increased as a result of repeated anti-tuberculosis and anti-infection therapy.4. The rate of drug resistance has increased as a result of anti-infection therapy in repeated treatment group.