心脏移植术后早期病原菌分布及耐药性分析

Pathogens in Early Period after Heart Transplantation and Their Drug-resistance

目的了解心脏移植术后早期病原菌种类及其耐药性。方法对医院2004年6月-2006年9月心脏移植术后早期感染的病原菌进行分类并对其耐药性进行分析。结果在121株病原菌中G-杆菌占73.6%;G+球菌占17.4%;真菌占9.1%;G-杆菌中位居前5位的病原菌依次为肺炎克雷伯菌、阴沟肠杆菌、鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌,对头孢哌酮/舒巴坦、头孢吡肟、哌拉西林/他唑巴坦敏感率高,三代头孢中头孢他啶优于头孢噻肟,除铜绿假单胞菌对亚胺培南敏感率为87.0%外,其他G-杆菌均对其100.0%敏感;G+球菌主要为耐甲氧西林凝固酶阴性葡萄球菌(MRCNS),甲氧西林敏感金黄色葡萄球菌(MSSA)及肠球菌,未出现耐万古霉素葡萄球菌和肠球菌;真菌类中以白色假丝酵母菌为主,所有真菌对氟康唑、伊曲康唑、两性霉素B敏感,另分离烟曲霉菌1株。结论研究心脏移植术后早期病原菌分布及耐药性分析,为心脏移植术后感染的预防与控制提供指导作用。

OBJECTIVE To investigate the pathogens in the early period after heart transplantation and analyze their drug-resistance. METHODS The pathogens in the early period after heart transplantation were identified and their drug-resistance was analyzed. RESULTS From all of the 121 pathogens,the rate of G^- bacilli was 73.6%, the rate of G^＋ cocci was 17.4%and the rate of fungi was 9.1% ; G^- bacilli mainly consisted of Klebsiella pneumoniae, Enterobacter Cloacae, ACinetobacter baumannii , Pseudornonas aeruginosa and Escherichia coli, G^- bacilli showed higher sensitive rates to sulbactam/cefoperazone, cefepime, piperacillin/tazobactam and ceftazidime than to cefotaxime. All G^- bacilli showed sensitive to imipenem except Pseudomonas aeruginosa. G^＋ cocci mainly consisted of negative coagulase Staphylococcus, Staphylococcus aureus and Enterococcus. Fungi mainly consisted of Candida,and they were sensitive to fluconazole,itraconazole and amphotericin B. CONCLUSIONS To observe the pathogens in the early period after heart transplantation and analyze their drug-resistance are important to control and prevent the infection efficiently for the heart transplantation recipients.