肺源性心脏病患者呼吸道感染病原菌分布及耐药性分析

发布时间：2018-07-17 16:46

【摘要】：目的探讨肺源性心脏病患者伴发呼吸道感染的病原菌及耐药性,为临床抗菌方案的制定提供依据。方法回顾性分析医院自2013年1月-2016年11月收治的218例肺源性心脏病伴发呼吸道感染患者的临床资料,分析患者的痰培养结果,统计病原菌分布及其对常见抗菌药物的耐药性情况。结果 218例患者共送检痰标本338次,培养出303株病原菌,其中革兰阴性菌151株,占49.84%,革兰阳性菌80株,占26.40%,真菌72株,占23.76%;发生二重感染20例次,发生混合感染39例;革兰阳性菌对红霉素、克林霉素均表现出高度耐药性,耐药率均80.00%,对万古霉素具有较高的敏感性,其中金黄色葡萄球菌、溶血葡萄球菌和表皮葡萄球菌对青霉素、头孢唑林、头孢曲松的耐药率均70.00%;革兰阴性菌对头孢吡肟、头孢噻肟的耐药率均50.00%,铜绿假单胞菌对除他唑巴坦外的所有常用抗菌药物的耐药率均30.00%;肺炎克雷伯菌对环丙沙星和美罗培南有较高的敏感性;大肠埃希菌对亚胺培南和美罗培南有较高的敏感性;鲍氏不动杆菌对除庆大霉素外的所有常用抗菌药物的耐药率均50.00%。结论肺源性心脏病患者伴发呼吸道感染的病原菌以革兰阴性菌居多,且耐药性严重,临床应进一步规范抗菌药物的应用,减少耐药菌的产生。
[Abstract]:Objective to investigate the pathogenic bacteria and drug resistance in patients with pulmonary heart disease associated with respiratory tract infection. Methods the clinical data of 218 patients with pulmonary heart disease associated with respiratory tract infection from January 2013 to November 2016 were retrospectively analyzed and the results of sputum culture were analyzed. The distribution of pathogens and their resistance to common antimicrobial agents were analyzed. Results 303 strains of pathogenic bacteria were cultured out of 338 sputum samples from 218 patients, of which 151 were Gram-negative bacteria (49.84), 80 Gram-positive bacteria (26.40m), 72 fungi (23.766B), 20 cases of double infection (39 cases) and 39 cases of mixed infection (39 cases). Gram-positive bacteria showed high resistance to erythromycin and clindamycin, and the drug resistance rates were 80.00and had high sensitivity to vancomycin. Staphylococcus aureus, Staphylococcus haemolyticus and Staphylococcus epidermidis showed high resistance to penicillin and cefazolin. The resistance rate of ceftriaxone to cefepime was 70.00g%, and that of Gram-negative bacteria to cefepime. The drug resistance rate of cefotaxime was 50.00cm, the resistance rate of Pseudomonas aeruginosa to all common antimicrobial agents except tazobactam was 30.00g, Klebsiella pneumoniae had high sensitivity to ciprofloxacin and meropenem. Escherichia coli was highly sensitive to imipenem and meropenem, and Acinetobacter baumannii was resistant to all common antimicrobial agents except gentamicin. Conclusion Gram-negative bacteria are the main pathogens associated with respiratory tract infection in patients with pulmonary heart disease, and their drug resistance is serious. The clinical application of antimicrobial agents should be further standardized to reduce the production of drug-resistant bacteria.
【作者单位】：安阳市人民医院心血管内科一病区;安阳市人民医院呼吸内科;安阳市人民医院心血管内科三病区;安阳市人民医院心脏外科;
【分类号】：R541.5

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