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经门诊用1～2种抗生素,治疗3～5天疗效不明显的支气管肺炎病例共415例,经声门下吸引取呼吸道分泌物作细菌培养及分离,共获503株细菌,球菌338株(67.2％),杆菌165株(32.8％)。415例中混合感染88例,占21.2％。503株细菌中122株伴有细菌L型,占24.3％,其中球菌78株(63.9％),杆菌44株(36.1％)。金葡菌L型及大肠杆菌L型所占比重较大。药敏试验提示除耐甲氧西林金葡菌(MRSA)和绿脓杆菌外,头孢唑啉、西力欣和凯福隆、氨基甙类及氯霉素等均有较好的抗菌作用。去甲万古霉素对MRSA有良好的作用。治疗中除考虑细菌对抗生素的耐药率以外,还应考虑混合感染及细菌L型的治疗。
A total of 415 bronchial pneumonia cases were treated with 1 or 2 antibiotics in clinic for 3 to 5 days. A total of 503 bacteria and 338 strains of cocci (67.2 %), 165 strains of Bacillus (32.8%). In 415 cases, 88 cases were mixed infection, accounting for 21.2%. Of the 503 strains of bacteria, 122 were L-type bacteria, accounting for 24.3%. Of these, 78 strains were cocci (63.9%) and 44 strains were Bacillus (36.1%). Staphylococcus aureus L-type and Escherichia coli L-type accounted for a larger proportion. Susceptibility tests suggest that in addition to methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa, cefazolin, celecoxib and Kai Fulong, aminoglycosides and chloramphenicol have a good antibacterial effect. Norvancomycin has a good effect on MRSA. In addition to considering the bacterial resistance to antibiotics in the treatment, should also consider the mixed infection and bacterial L-type treatment.