先天性心脏病患者呼吸机相关性肺炎病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens isolated from congenital heart disease patients with ventilator-associated pneumonia

作　　者：刘艳琰[1] 李斌[2] 段雷波[3] 曹义[1] 付爱国[1] 韩利红[1] 

机构地区：[1]郑州大学附属洛阳中心医院呼吸内科,河南洛阳471000 [2]郑州大学附属洛阳中心医院心外科,河南洛阳471000 [3]中国空空导弹研究院零一四医院医技科,河南洛阳471000

出　　处：《中华医院感染学杂志》2016年第13期2954-2956,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅科技攻关基金资助项目(2013098987HJ)

摘　　要：目的探讨先天性心脏病患者呼吸机相关性肺炎病原菌分布及耐药性,为患者治疗过程中抗菌药物的合理应用提供参考依据。方法选取2009年1月-2014年12月心外科ICU和RICU收治的先天性心脏病呼吸机相关性肺炎患者195例,用珠海迪尔生物细菌测定系统和法国生物梅里埃公司VITEK-2Compact全自动微生物鉴定系统对送检标本进行病原菌鉴定,采用纸片扩散法进行药敏试验;采用SPSS 18.0软件对数据进行统计分析。结果从195例患者送检标本中分离病原菌212株,其中革兰阴性菌153株占72.17%,革兰阳性菌39株占18.40%,真菌20株占9.43%;肺炎克雷伯菌、铜绿假单胞菌等对氨苄西林、头孢呋肟和头孢西汀的耐药率均较高,均达到85.00%以上;凝固酶阴性葡萄球菌对青霉素、头孢唑林、阿莫西林和氨苄西林等的耐药率均较高,达到90.00%以上。结论调查分析病原菌分布及耐药性,为先天性心脏病患者呼吸机相关性肺炎治疗过程中合理选用抗菌药物、缩短病程、促进康复均具有十分重要的指导意义。OBJECTIVE To explore the distribution and drug resistance of pathogens isolated from congenital heart disease patients with ventilator-associated pneumonia so as to provide guidance for reasonable use of antibiotics during the treatment.METHODS A total of 195 congenital heart disease patients with ventilator-associated pneumonia who were treated in the ICU and RICU of cardiac surgery department from Jan 2009 to Dec 2014 were enrolled in the study,then the pathogens that were isolated from the submitted specimens were identified by using the bacterial identification system of Zhuhai DL Biotech Co.,Ltd and VITEK-2Compact automatic microbial identification system of BioMérieux,France,the drug susceptibility testing was carried out by means of disk diffusion method,and the statistical analysis of data was performed with the use of SPSS 18.0software.RESULTS Totally212 strains of pathogens were isolated from the submitted specimens that were obtained from the 195 patients,including 153（72.17%）strains of gram-negative bacteria,39（18.40%）strains of gram-positive bacteria,and 20（9.43%）strains of fungi.The drug resistance rates of the Klebsiella pneumoniae and Pseudomonas aeruginosato ampicillin,cefuroxime,and cefoxitin were more than 85.00%;the drug resistance rates of the coagulase-negative Staphylococcus to penicillin,cefazolin,amoxicillin,and ampicillin were more than 90.00%.CONCLUSION It is of great significance to investigate the distribution and drug resistance of the pathogens isolated from the congenital heart disease patients with ventilator-associated pneumonia so as to reasonably use antibiotics,shorten the disease course,and promote the rehabilitation.

关 键 词：先天性心脏病 呼吸机相关性肺炎 病原菌 分布 耐药性 

分 类 号：R563.1[医药卫生—呼吸系统]