先天性心脏病合并感染性心内膜炎患儿病原菌培养及其耐药性分析

发布时间：2018-08-05 13:00

【摘要】：目的研究先天性心脏病合并感染性心内膜炎患儿的病原菌种类,并分析其耐药性,为临床诊疗以及抗菌药物的选择提供参考。方法本院2010年9月至2016年8月收入院的先天性心脏病合并感染性心内膜炎患儿68例,通过血培养统计其病原菌种类及构成,并进行药敏试验。结果 98例患儿细菌血培养阳性38例,共分离出致病菌57株。其中革兰阳性菌41株,占71.93%,主要以草绿色链球菌多见,构成比为36.84%(21/57);革兰阴性菌16株,占28.07%,主要以大肠埃希菌为主,构成比为12.28%(7/57)。草绿色链球菌对阿米卡星、红霉素、克林霉素敏感性较低,对其他抗菌药物的敏感性均超过80%;金黄色葡萄球菌对复方新诺明、万古霉素、替考拉林、亚胺培南的敏感性均为100%,肠球菌对头孢吡肟、阿米卡星、复方新诺明、左氧氟沙星、万古霉素、替考拉林、亚胺培南敏感性均为100%,凝固酶阴性葡萄球菌对万古霉素、替考拉林、亚胺培南敏感性均为100%,大肠埃希菌对阿米卡星、亚胺培南敏感性均为100%。结论先天性心脏病合并感染性心内膜炎患儿的致病菌多数为革兰阳性球菌,且以草绿色链球菌为主。主要致病菌对万古霉素、替考拉林、亚胺培南均敏感性,但除草绿色链球菌外,其它病原菌对青霉素均不敏感。
[Abstract]:Objective to study the pathogenic bacteria in children with congenital heart disease complicated with infective endocarditis, and to analyze their drug resistance, and to provide reference for clinical diagnosis and treatment and choice of antimicrobial agents. Methods from September 2010 to August 2016, 68 children with congenital heart disease complicated with infective endocarditis were enrolled in our hospital. Results among 98 children, 38 cases were positive for bacterial blood culture, 57 strains of pathogenic bacteria were isolated. There were 41 Gram-positive bacteria (71.93%), mainly Streptococcus viridis (36.84%, 21 / 57), 16 Gram-negative bacteria (28.07%), mainly Escherichia coli (12.28%, 757%). Streptococcus graminis is less sensitive to amikacin, erythromycin, clindamycin, and is more sensitive to other antimicrobial agents than 80. Staphylococcus aureus is more sensitive to compound sulfamethoxine, vancomycin, teicoplanin, The sensitivity of Enterococcus to cefepime, amikacin, compound sulfamine, levofloxacin, vancomycin, teicoplanin and imipenem were 100. The sensitivity of imipenem was 100 and that of Escherichia coli to amikacin and imipenem were 100. Conclusion Gram-positive cocci are the most pathogenic bacteria in children with congenital heart disease and infective endocarditis, and streptococcus graminis is the main pathogen. The main pathogens were sensitive to vancomycin, teicoplanin and imipenem, but the other pathogens were not sensitive to penicillin except Streptococcus viridis.
【作者单位】：华中科技大学同济医学院附属武汉儿童医院心胸外科;
【分类号】：R725.4

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