医院近10年来感染性心内膜炎患者病原菌分布及耐药性分析

发布时间：2018-08-29 20:22

【摘要】：目的探讨医院10年来感染性心内膜炎患者病原菌分布,并对其临床耐药性进行研究分析,为临床上合理使用药物提供可参考依据。方法采用回顾性分析方法选择2008年1月-2016年1月286例医院心内科诊断为感染性心内膜炎的患者为研究对象,详细记录其相关信息,采用VITEK2Compact及配套的鉴定卡和药敏卡来完成血培养的病原菌分析及药敏试验。结果 286例感染性心内膜炎患者中208例患者血培养阳性,阳性率为72.7%,共分离检出288株菌株,其中革兰阳性菌为156株,占54.2%,革兰阴性菌为92株,占31.9%,真菌40株,占13.9%,革兰阳性菌对利奈唑胺的敏感性最高,其次为万古霉素及莫西沙星,对青霉素耐药性最高,其次为苯唑西林;革兰阴性菌对亚胺培南最敏感,其次为美罗培南;真菌对氟康唑最敏感,其次为伏立康唑。结论感染性心内膜炎病原菌比例发生变化,革兰阳性菌株比例降低,而革兰阴性菌株及真菌比例增高。在临床实际工作中,需要及时查明病原菌及药敏情况以便针对性治疗。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria in patients with infective endocarditis in hospital during the past 10 years and to analyze their clinical drug resistance so as to provide reference for the rational use of drugs in clinic. Methods 286 patients diagnosed as infective endocarditis in hospital from January 2008 to January 2016 were selected by retrospective analysis, and the relevant information was recorded in detail. VITEK2Compact and associated identification cards and drug sensitive cards were used to analyze pathogenic bacteria and drug sensitivity test in blood culture. Results of the 286 patients with infective endocarditis, 208 were positive in blood culture, the positive rate was 72.7. A total of 288 strains were isolated, of which 156 were Gram-positive bacteria (54.2%), 92 were Gram-negative bacteria (31.9B), and 40 were fungi. Gram-positive bacteria had the highest sensitivity to linazolamine, vancomycin and moxifloxacin, penicillin and oxacillin, Gram-negative bacteria were most sensitive to imipenem and meropenem. Fungi were most sensitive to fluconazole, followed by Volconazole. Conclusion the proportion of pathogenic bacteria in infective endocarditis changed, the proportion of Gram-positive strains decreased, while the proportion of Gram-negative strains and fungi increased. In clinical practice, it is necessary to identify pathogens and drug sensitivity in time for targeted treatment.
【作者单位】：南阳医学高等医学专科学校第一附属医院心脏外科;
【基金】：河南省教育厅自然科学基金项目(13A326621)
【分类号】：R542.41

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