慢性充血性心力衰竭患者下呼吸道多重耐药菌感染的临床研究

Multiple multi-drug resistant respiratory infection in patients with chronic congestive heart failure under

目的 研究慢性充血性心力衰竭患者下呼吸道多重耐药菌感染的临床特点,为合理选用抗生素防控下呼吸道多重耐药菌感染提供依据.方法 选取2010年4月～2013年5月收治的慢性充血性心力衰竭合并下呼吸道多重耐药菌感染的188例患者为研究对象,随机分为两组,实验组94例根据药敏试验结果调整抗生素治疗,对照组94例采用广谱抗生素治疗.采用不同方式治疗两周后,分别观察两组慢性充血性心力衰竭患者下呼吸道耐药菌感染的临床治疗效果并进行统计学分析.结果 实验组总有效率为88.3％,总满意率为78.7％.对照组总有效率72.3％,总满意率59.6％,两组比较差异有统计学意义（P＜0.05）.结论 慢性充血性心力衰竭患者下呼吸道多重耐药菌感染多为革兰阴性杆菌感染,真菌感染较少见.根据药敏试验结果,合理选用抗生素治疗效果明显高于广谱抗生素,为临床合理选用抗生素防控下呼吸道多重耐药菌感染提供依据.

Objective To study the clinical features of patients with chronic congestive heart failure by multi drug resistant bacteria infection of respiratory tract, for reasonable selection of antibiotics in lower respiratory tract provides the basis for the prevention and control of multi drug resistant bacteria infection. Methods 188 patients with multi drug resistant bacteria infection with chronic congestive heart failure with lower respiratory tract were randomly divided into two groups. 94 cases were in experimental group according to the result of drug sensitivity test to adjust antibiotic thera- py. 94 cases were in the control group using broad-spectrum antibiotic treatment. The clinical therapeutic effects of two groups were observed. Results Before treatment, the experimental group showed positive sputum culture with 57.8% gram negative bacilli, 28. 1% gram positive bacteria and 14. 1% fungi. The control group showed positive sputum culture with 58% gram negative bacilli, 32.8% gram positive bacteria and 9.2% fungi. Pathogen distribution in the two groups of patients before treatment was not diffierent （P〉0. 05）. The total effective rate of experimental group and control group were 88.3% and 72.3% （P〈0.05）. The study group according to the treatment to adjust antibiotic susceptibility test results, the satisfactory rate was 78.7%. Conclusion In patients with chronic congestive heart failure and bacterial multidrug resistant respiratory infection are gram negative bacilli infection. The fungal infection is rare. According to the results of drug sensitive test, rational use of antimicrobial treatment is significantly effective than that of spectrum antibiotics.