感染性心内膜炎病原菌种类分布及耐药性分析  

Distribution and drug resistance of pathogens causing infective endocarditis

作　　者：杨剑[1] 

机构地区：[1]杭州钢铁集团公司职工医院心血管内科,浙江杭州310022

出　　处：《中华医院感染学杂志》2011年第21期4603-4604,共2页Chinese Journal of Nosocomiology

摘　　要：目的通过对感染性心内膜炎(IE)患者分离病原菌及其耐药率的分析,探讨IE病原菌的分布及临床抗菌药物的应用情况。方法对医院2007年1月-2010年12月收治的80例IE患者,分离的病原菌及抗菌药物耐药情况进行回顾性分析。结果统计的IE病原菌中,革兰阳性球菌65株占81.3%,其中酿脓链球菌55株占84.6%;革兰阴性杆菌11株占13.8%,其中嗜麦芽寡养单胞菌7株;真菌4株占5.0%,均为白色假丝酵母菌;体外药物敏感性试验发现,感染菌株中革兰阳性菌株对万古霉素、利奈唑胺的敏感性均为100.0%,而对苯唑西林、青霉素、红霉素等敏感性较低,而革兰阴性菌对左氧氟沙星、磺胺甲噁唑/甲氧苄啶的敏感性较高。结论酿脓链球菌仍然是IE的主要病原菌,对万古霉素、利奈唑胺耐药率较低;嗜麦芽寡养单胞菌感染为IE主要革兰阳性菌,其对左氧氟沙星、磺胺甲噁唑/甲氧苄啶耐药率较低;及时掌握其动态变化,做好抗菌药物的宏观管理,对遏制耐药菌的产生具有重要意义。OBJECTIVE To investigate the distribution of the pathogenic bacteria and study the reasonable use of antibiotic by analyzing the drug resistant rate of the bacteria separated from IE patients. METHODS The distribution and the using of antibiotic of the pathogen bacteria separated from eighty IE patients in our hospital during Jan 2007 to Dec 2010, were retrospectively analyzed. RESULTS There were sixty-five strains gram positive organism in all the pathogen bacteria separated from IE patients （account for 81.3%）, of which the Streptococci viridans were fifty-five strains, accounting for 84. 6% there were eleven strains Gram-negative organism, accounting for 15.8 %. There were seven Stenotrophornonas maltophilia strains; there were four strains of fungi, which all were Candida albicans. In vitro drug sensitivity test, we found that the Gram-positive bacteria were more sensitive to vancomycin and linezolid, but more resistant to oxacillin, penicillin and erythromycin. However, the Gram-negative bacteria were more sensitive to levofloxacin and compound sulfamethoxazole. CONCLUSION Streptococcus viridans is still the main pathogenic bacterium, and is more sensitive to vancomycin and linezolid; Stenotrophomonas maltophilia is the main Gram-negative bacteria, which is more sensitive to levofloxacin and compound suifamethoxazole. To grasp its dynamic change and macro management to the antibiotic is important to control the production of the resistant bacteria.

关 键 词：感染性心内膜炎 病原菌 抗菌药物 耐药率 

分 类 号：R378[医药卫生—病原生物学]