老年冠心病患者医院感染病原学特点及耐药性分析

发布时间：2019-06-14 10:47

【摘要】：目的探讨老年冠心病患者医院感染的病原菌分布及耐药性。方法选取2014年12月-2016年2月医院诊治的216例老年冠心病医院感染患者的资料进行分析,采集患者痰液、血液及分泌物进行病原菌培养,采用最小抑菌浓度(MIC)法进行体外药敏试验,分析老年冠心病医院感染患者病原菌分布及耐药性,根据病原菌耐药性情况提出相应的解决对策。结果老年冠心病患者医院感染部位以呼吸道、尿路、胃肠道为主;216例老年冠心病医院感染中共分离出234株病原菌,其中革兰阴性菌138株占58.97%,以铜绿假单胞菌和大肠埃希菌为主;革兰阳性菌61株占26.07%,以金黄色葡萄球菌和表皮葡萄球菌为主;真菌35株占14.96%,以白色假丝酵母菌和曲霉菌属为主;铜绿假单胞菌对氨苄西林/舒巴坦、哌拉西林、头孢曲松及头孢他啶耐药率较高,均为78.26%;大肠埃希菌对阿莫西林/克拉维酸和哌拉西林耐药率较高,均为81.48%。金黄色葡萄球菌和表皮葡萄球菌对环丙沙星和红霉素耐药率较高,分别为54.84%、51.61%和44.44%、55.56%。结论老年冠心病医院感染病原菌主要以革兰阴性菌为主,且耐药性较高,应选择敏感抗菌药物进行治疗,提高治愈率。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in elderly patients with coronary heart disease (CAD). Methods the data of 216 elderly patients with coronary heart disease (CAD) from December 2014 to February 2016 were analyzed. Sputum, blood and secretions were collected for pathogen culture. The drug sensitivity test in vitro was carried out by (MIC) method. The distribution and drug resistance of pathogenic bacteria in elderly patients with coronary heart disease (CAD) were analyzed, and the corresponding countermeasures were put forward according to the drug resistance of pathogenic bacteria. Results 234 strains of pathogenic bacteria were isolated from 216 elderly patients with coronary heart disease, including 138 strains of Gram-negative bacteria, mainly Pseudomonas aeruginosa and Escherichia coli, 61 strains of Gram-positive bacteria, mainly Staphylococcus aureus and Staphylococcus epidermidis, and 234 strains of pathogenic bacteria were isolated from 216 elderly patients with coronary heart disease, including respiratory tract, urinary tract and gastrointestinal tract, and 234 strains of pathogenic bacteria, including 138 strains of Gram-negative bacteria (58.97%) and 61 strains of Gram-positive bacteria (26.07%). 35 strains of fungi accounted for 14.96%, mainly Pseudomonas albicans and Aspergillus, Pseudomonas aeruginosa had higher resistance to ampicillin / sulbactam, piperacillin, ceftriaxone and ceftazidime, and Escherichia coli had higher resistance to amoxicillin / clavulanic acid and piperacillin, all of which were resistant to ampicillin / sulbactam, ceftriaxone and ceftazidime. The resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to ciprofloxacin and erythromycin were 54.84%, 51.61% and 44.44% respectively, and the resistance rates of Staphylococcus epidermidis to ciprofloxacin and erythromycin were 54.84%, 51.61% and 44.44% respectively. Conclusion Gram-negative bacteria are the main pathogens of hospital infection in elderly patients with coronary heart disease, and the drug resistance is high. Sensitive antibiotics should be selected for treatment to improve the cure rate.
【作者单位】：重庆市中医院呼吸科;
【基金】：重庆市卫计委基金资助项目(2014-2-072)
【分类号】：R541.4

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