Clinical analysis on 36 cases of coal workers' pneumoconiosis complicated with pulmonary tuberculosis and nosocomial infection of stenotrophomonas maltophilia / 中国职业医学

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics of the coal workers' pneumoconiosis( CWP) complicated with both tuberculosis and nosocomial infection of stenotrophomonas maltophilia. METHODS: The clinical data of 36 CWP patients complicated with tuberculosis and nosocomial infection of stenotrophomonas maltophilia were collected and retrospectively analyzed. RESULTS: The results of sputum cultured for more than 3 times showed positive stenotrophomonas maltophilia. The main clinical manifestations were cough,sputum,fever and wet rale of lung. Most of the chest X-rays showed light and patchy infiltrated shadows. Drug susceptibility testing indicated that this kind of bacteria was extensively drug-resistant. The drug resistance rates to imipenem,cefepime,aztreonam and cefoperazone were 100. 0%,96. 1%,94. 5% and 89. 8%,respectively. The sensitivity of patients to sulfanilamide methyl isopropyl pbo, ciprofloxacin,levofloxacin and gentamicin were > 60. 0%. After antituberculosis therapy combined with 2 or more sensitive antibiotics treatment based on the sputum cultured results,there were 21 cases( 58. 3%) cured,2 cases( 5. 6%) improved,3 cases( 8. 3%) ineffective and 10 cases( 27. 8%) dead. CONCLUSION: The clinical features of tuberculopneumoconiosis combined with the nosocomial infection of stenotrophomonas maltophilia are un-typical. This disease is severely antibiotic-resistant.Timely pathogenic bacteria culture and drug sensitivity test have important significance in diagnosis and treatment.