心脏手术患者围术期感染病原菌与耐药性研究  

Pathogens causing infections in patients with cardiac surgeries during perioperative period and the drug resistance

作　　者：张荣泽[1] 李晓峰[1] 张玉芬[1] 付立萍[1] 朱希燕[1] 

机构地区：[1]河北医科大学第四医院心脏外科,河北石家庄050011

出　　处：《中华医院感染学杂志》2015年第24期5628-5630,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅基金资助项目(1020140189)

摘　　要：目的探讨心脏手术患者围术期感染的病原菌与耐药性,为临床合理用药提供参考依据。方法选取2012年1月-2015年4月100例心脏手术围术期感染患者为研究对象,对患者送检标本检出的病原菌分布和药敏试验进行分析,采用法国生物梅里埃公司VITEK-2全自动细菌鉴定药敏分析仪进行细菌鉴定与药敏试验,数据采用SPSS 17.0软件进行统计分析。结果 100例患者共分离出138株病原菌,其中以痰液和胸水标本为主,分别占44.2%和29.7%,检出病原菌中以革兰阴性菌为主,占65.9%;大肠埃希菌、肺炎克雷伯菌对妥布霉素和阿莫西林的耐药率最高,均为100.0%,铜绿假单胞菌对磺胺甲噁唑/甲氧苄啶的耐药率最高为88.2%,鲍氏不动杆菌对氨曲南的耐药率最高为78.7%;金黄色葡萄球菌、表皮葡萄球菌及溶血葡萄球菌对青霉素的耐药率最高,均为100.0%。结论心脏手术围术期感染病原菌普遍具有耐药性,应当合理使用抗菌药物,预防感染。OBJECTIVE To explore pathogens causing infections in patients with cardiac surgeries during perioperarive period and the drug resistance so as to provide references for clinical rational use of antibiotics. METHODS From Jan. 2012 to Apr. 2015, 100 patients, who received cardiac surgeries and appeared infections during perioperative period were chosen as study objects. VITEK-2 automatic bacteria identification and drug sensitivity analyzer were used to detect the bacteria and drug sensitivities. All data were statistically analyzed by SPSS 17. 0. RESULTS Totally 138 strains of pathogens were isolated from the 100 patients, mainly dominated by sputum samples and hydrothorax samples, accounting for 44.2% and 29.7%. Gram-negative bacteria were the major pathogens in the samples, holding 65.9%. Escherichia coli and Klebsiella pneumoniae were proved to be 100 %resistant to tobramycin and amoxicillin. Pseudomonas aeruginosa were highly resistant to sulfamethoxazole and trimethoprim with the rate of 88.2%. Acinetobacterbaumannii were resistant to aztreonam with the rate up to 78.7%. Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus were 100% resistant to penicillin. CONCLUSION Pathogens causing infections in patients with cardiac surgeries during perioperative period are proved to be highly drug resistant. Antibiotics should be used rationally to prevent infections.

关 键 词：心脏手术 围术期 感染 病原菌 耐药性 

分 类 号：R619.3[医药卫生—外科学]