老年心力衰竭患者肺部感染的病原菌分析及控制对策

发布时间：2018-02-03 20:41

本文关键词： 心力衰竭老年肺部感染病原菌　出处：《中华医院感染学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的分析老年心力衰竭患者肺部感染的病原菌检测结果,提出控制对策,为老年心力衰竭患者肺部感染的控制提供参考。方法选取2013年1月-2015年12月202例老年心力衰竭肺部感染患者,采集患者痰液标本送实验室进行病原菌培养及药物敏感试验,对结果进行评定及统计分析。结果 202份痰液标本培养阳性率为59.90%,共培养出病原菌154株,其中一种、两种、三种及以上病原菌感染分别占病原菌培养阳性患者的77.69%、18.18%、4.13%,病原菌中革兰阴性菌、革兰阳性菌、真菌构成比分别占59.74%、35.71%、4.55%,革兰阴性菌中肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌、阴沟肠杆菌为主要病原菌,分别占感染病原菌的15.58%、12.34%、11.04%、7.14%、5.19%,革兰阳性菌中金黄色葡萄球菌、肺炎链球菌、凝固酶阴性葡萄球菌、肠球菌属为主要感染病原菌,分别占11.04%、9.09%、6.49%、4.55%,真菌主要为白假丝酵母菌,占3.25%;革兰阴性菌和革兰阳性菌对多种抗菌药物耐药率均较高,肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌仅对亚胺培南耐药率30.00%,金黄色葡萄球菌、肺炎链球菌、凝固酶阴性葡萄球菌仅对万古霉素耐药率30.00%。结论老年心力衰竭患者肺部感染的病原菌以革兰阴性菌为主,对常用抗菌药物耐药率较高,应针对老年心力衰竭患者自身特点采取多种措施降低肺部感染。
[Abstract]:Objective to analyze the detection results of pulmonary infection in elderly patients with heart failure and to put forward control measures. Methods A total of 202 elderly patients with heart failure from January 2013 to December 2015 were selected. Samples of sputum were collected and sent to the laboratory for pathogen culture and drug sensitivity test. The results were evaluated and statistically analyzed. Results the positive rate of sputum culture was 59.90%. A total of 154 strains of pathogenic bacteria were cultured, of which one, two, three or more accounted for 77.6918.184.13% of the positive cases, respectively. The proportion of Gram-negative bacteria, Gram-positive bacteria and fungal composition of Gram-negative bacteria accounted for 35.71 and 4.55 respectively. Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were found in Gram-negative bacteria. Acinetobacter baumannii and Enterobacter cloacae were the main pathogens, accounting for 15.58% of the pathogenic bacteria of infection. Among Gram-positive bacteria, Staphylococcus aureus, Streptococcus pneumoniae, coagulase negative Staphylococcus and Enterococcus were the main infectious pathogens, accounting for 11.04% 9.09% and 6.49% respectively. 4.55 the main fungi were Candida albicans (3.25%). The resistance rate of Gram-negative bacteria and Gram-positive bacteria to various antimicrobial agents was higher. The resistance rate of Klebsiella pneumoniae Escherichia coli Pseudomonas aeruginosa and Acinetobacter baumannii was only 30.00% to imipenem. Staphylococcus aureus, Streptococcus pneumoniae and coagulase-negative staphylococcus were only resistant to vancomycin. Conclusion Gram-negative bacteria are the main pathogens of pulmonary infection in elderly patients with heart failure. The rate of drug resistance to common antibiotics is high. According to the characteristics of elderly patients with heart failure, various measures should be taken to reduce pulmonary infection.
【作者单位】：河南大学淮河医院心内科;
【基金】：河南省医学科技攻关计划基金资助项目(2013040122)
【分类号】：R541.6;R563.1
【正文快照】： 心力衰竭是指心脏收缩功能和(或)舒张功能发生障碍,静脉回心血量不能充分排出心脏,在静脉内发生淤血,动脉系统内则表现为血流灌注不足,从而引起心脏循环障碍症候群发生,这种症候群主要表现为体循环和肺循环淤血,心力衰竭并非单一疾病,是心肌病、心肌梗死、风心病等各种心脏疾

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