心血管疾病患者肺部感染病原菌分布与耐药性分析

Distribution of pathogens causing lung infections in patients with cardiovascular disease and the drug resistance analysis

目的探讨心血管疾病患者肺部感染常见病原菌的分布及其耐药性,为临床合理用药提供参考依据。方法选取2014年1月-2015年1月收治的240例心血管疾病患者为研究对象,观察患者肺部感染发生情况;采用西门子Walkaway全自动微生物鉴定及药敏分析仪,对肺部感染患者痰液分离的病原菌进行鉴定及药敏分析,数据采用SPSS17.0软件进行统计分析。结果 240例心血管疾病患者发生肺部感染21例,感染率为8.75%;肺部感染患者共分离出病原菌32株,其中革兰阴性菌21株占65.62%,革兰阳性菌10株占31.25%,真菌1株占3.13%;革兰阴性菌对阿米卡星、亚胺培南、美罗培南以及哌拉西林的耐药率为0,对头孢吡肟、头孢唑林、甲氧苄啶、环丙沙星及左氧氟沙星的耐药率≥50.00%;革兰阳性菌对青霉素和氨苄西林的耐药率均达100.00%,对头孢唑林、红霉素、克林霉素和甲氧嘧啶耐药率均≥60.00%。结论心血管疾病患者应严格掌握抗菌药物的药敏性,合理选用抗菌药物。

OBJECTIVE To investigate the distribution of common pathogens causing lung infections in patients with cardiovascular disease and the drug resistance so as to provide a basis for rational use of antibiotics .METHODS A total of 240 cases of patients with cardiovascular disease admitted from Jan .2014 to Jan .2015 were chosen as study objects .Their lung infection condition was observed .Walkaway automated microbial identification and drug susceptibility analyzers produced by Siemens were used to identify pathogens isolated from sputum of lung infected patients and drug sensitivity analysis was conducted to these pathogens .All data were statistically analyzed by SPSS 17 .0 software .RESULTS Among 240 cases of cardiovascular disease patients ,21 cases were associated with pulmonary infections ,and the infection rate was 8 .75% .Totally 32 strains of pathogens were isolated ,including 21 strains of gram‐negative bacteria ,which accounted for 65 .62% ,10 strains of gram‐positive bacteria accounted for 31 .25% ,and 1 strain of fungi ,accounting for 3 .13 % .Gram‐negative bacteria were totally sensitive to amika‐cin ,imipenem ,meropenem and piperacillin .The drug resistance rate of gram‐negative bacteria to cefepime ,ce‐fazolin ,trimethoprim ,ciprofloxacin and levofloxacin was above 50 .00% .Gram‐positive bacteria were 100 .00%resistant to penicillin and ampicillin ,but the drug resistance rate to cefazolin ,erythromycin ,clindamycin ,and me‐thicillin was above 60 .00% .CONCLUSION Patients with cardiovascular diseases should be strictly controlled in drug susceptibility of antibiotics ,which should be rational used .