心力衰竭患者肺部感染致病菌分布及其对常见抗菌药的耐药性测定

Distribution of pathogens and their susceptibility to common antibiotics among heart failure patients complicated bypulmonary infections

目的分析心力衰竭患者肺部感染呼吸道分泌物样本中的病原菌分布,并测定其对常见抗菌药物的耐药性。方法以2021年2月至2024年1月收治的144例心力衰竭合并肺部感染患者为研究对象。采集患者呼吸道分泌物样本进行病原菌鉴定,采用圆纸片扩散试验法测定分离的细菌菌株对常见抗菌药物的敏感性。结果共检出138株病原菌,以革兰阴性菌为主(占61.59%),其次为革兰阳性菌(占31.16%)和真菌(占7.25%)。革兰阳性菌以金黄色葡萄球菌为主(占分离菌株总数的17.39%);革兰阴性菌以铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌为主,分别占分离菌株总数的22.46%、14.49%和13.04%。金黄色葡萄球菌对利奈唑胺、呋喃妥因、利福平、万古霉素、奎奴普丁/达福普汀、替加环素完全敏感,对青霉素G耐药性最高。鲍曼不动杆菌对常见抗菌药物普遍耐药性,对氨苄西林、氨苄西林/舒巴坦、头孢唑啉、氨曲南完全耐药;肺炎克雷伯菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉完全耐药;铜绿假单胞菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉、头孢曲松、复方新诺明完全耐药,对哌拉西林/他唑巴坦、阿米卡星、庆大霉素、妥布霉素敏感性较高。结论革兰阴性菌是引发心力衰竭患者合并肺部感染的主要病原菌,且对氨苄西林、氨苄西林/舒巴坦、头孢唑啉等抗菌药物完全耐药。

Objective To investigate the distribution of pathogens in respiratory tract secretion specimens among heart failure patients complicated by pulmonary infections,and to test the susceptibility of pathogens to common antimicrobial agents.Methods A total of 144heart failure patients complicated by pulmonary infections from February 2021 to January 2024 were enrolled.Participants'respiratory tract secretion specimens were collected for identification of pathogens,and the susceptibility of bacterial isolates to common antimicrobial agents was tested using the K-B disk diffusion test.Results A total of 138 pathogens were isolated,and the proportions of Gram-negative bacteria,Gram-positive bacteria and fungi were 61.59%,31.16%and 7.25%,respectively.Staphylococcus aureus was the predominant Gram-positive bacteria(17.39%of all pathogens),and Pseudomonas aeruginosa,Klebsiella pneumonia and Acinetobacter baumannii were predominant Gram-negative bacteria,which consisted of 22.46%,14.49%and 13.04%of all pathogens.S.aureus was totally susceptible to linazolamide,furantoin,rifampicin,vancomycin,quinuputin/dafoputin and tigecycline,and showed the highest level of resistance to penicillin G.A.baumannii was resistant to common antimicrobial agents,and was totally resistant to ampicillin,ampicillin/sulbactam,cefozolin and aztreonam,and K.pneumonia was totally resistant to ampicillin,ampicillin/sulbactam and cefozolin,while P.aeruginosa was totally resistant to ampicillin,ampicillin/sulbactam,cefozolin,ceftriaxone and sulfamethoxazole and was highly susceptible to piperacillin/tazobactam,amikacin,gentamicin,and tobramycin.Conclusion Gram-negative bacteria are major pathogens for pulmonary infections among heart failure,and these bacterial isolates are totally resistant to ampicillin,ampicillin/sulbactam and cefozolin.