感染性心内膜炎常见病原菌分布与耐药性分析  

Distribution and drug resistance of common pathogens isolated from patients with infective endocarditis

作　　者：吴梓芳[1] 鲍翠玉[2] 高萍萍[1] 胡梅[2] 骆晓燕[2] 

机构地区：[1]武汉大学校医院物理诊断科,湖北武汉430072 [2]湖北科技学院心血管研究中心,湖北咸宁437100

出　　处：《中华医院感染学杂志》2015年第17期3872-3874,共3页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2008CDZ084)

摘　　要：目的探讨感染性心内膜炎患者的病原菌分布及其耐药性,为感染性心内膜炎患者的临床用药提供参考依据。方法选取医院2011年1月-2015年1月收治的感染性心内膜炎患者80例为研究对象,采用MicroScan WalkAway-40自动微生物鉴定系统对80例患者血清内的病原菌分布进行分析,采用药敏分析系统对病原菌进行耐药性分析。结果 80例感染性心内膜炎患者中检出病原菌139株,其中革兰阳性菌105株占75.54%,革兰阴性菌34株占24.46%;酿脓链球菌对四环素、克林霉素、红霉素的耐药率较高,均>61.00%,对青霉素、庆大霉素、氯霉素、利奈唑胺和万古霉素的耐药率为0;金黄色葡萄球菌对青霉素的耐药率最高,为90.91%,对左氧氟沙星和红霉素、利福平的耐药率较低,均<23.00%,对万古霉素耐药率为0;嗜麦芽寡养单胞菌对青霉素类、头孢菌素类及红霉素的耐药率较高,均>80.00%,对氨曲南、左氧氟沙星和美罗培南的耐药率为0;大肠埃希菌对青霉素、头孢唑林、头孢曲松及头孢哌酮的耐药率较高,均>90.00%,对呋喃妥因、氨曲南、左氧氟沙星、美罗培南及妥布霉素的耐药率为0。结论感染性心内膜炎患者其血清病原菌分布较广,临床医师应根据病原菌的耐药性,选择合适的抗菌药物,使疾病得到较好的治疗。OBJECTIVE To explore the distribution and drug resistance of the pathogens isolated from the patients with infective endocarditis so as to provide guidance for clinical use of antibiotics.METHODS A total of 80 patients with infective endocarditis who were treated in the hospital from Jan 2011 to Jan 2015 were recruited as the study objects.The pathogens isolated from the serum specimens of the 80 patients were analyzed by using MicroScan WalkAway-40 automatic microorganism identification system,and the drug resistance of the pathogens was observed by using drug susceptibility system.RESULTS Totally 139 strains of pathogens have been isolated from the80 patients with infective endocarditis,including 105（75.54%）strains of gram-positive bacteria and 34（24.46%）strains of gram-negative bacteria.The drug resistance rates of the Streptococcus pyogenes strains to tetracycline,clindamycin,and erythromycin were more than 61.000%;the drug resistance rates to penicillin,gentamicin,chloromycetin,linezolid,and vancomycin were 0.The drug resistance rate of the Staphylococcus aureus strains to penicillin was the highest（90.91%）,the drug resistance rates to levofloxacin,erythromycin,and rifampicin were less than 23.00%,and the drug resistance rate to vancomycin was 0.The drug resistance rates of the Stenotrophomonas maltophilia strains to penicillin,cephalosporins,and erythromycin were more than 80.00%,and the drug resistance rates to aztreonam,levofloxacin,and meropenem were 0.The drug resistance rates of the Escherichia coli strains to penicillin,cefazolin,ceftriaxone,and cefoperazone were more than 90.00%;the drug resistance rates to nitrofurantoin,aztreonam,levofloxacin,meropenem,and tobramycin were 0.CONCLUSION There are a variety of species of pathogens isolated from the serum specimens of patients with infective endocarditis.It is necessary for the clinicians to choose appropriate antibiotics according to the drug resistance of the pathogens so as to effectively treat the disease.

关 键 词：感染性心内膜炎 病原菌 血培养 耐药性 

分 类 号：R378[医药卫生—病原生物学]