感染性心内膜炎患者病原菌分布与预防  

Distribution and prevention of pathogens in patients with infective endocarditis

作　　者：赵爱萍[1] 庄芳[1] 潘庆华[1] 周艳丽[1] 商锟鹏[1] 

机构地区：[1]聊城市人民医院心内科,山东聊城252000

出　　处：《中华医院感染学杂志》2016年第15期3409-3411,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技厅基金资助项目(Z-2013-1-3-52-3)

摘　　要：目的探讨感染性心内膜炎患者感染病原菌分布及预防措施,从而提高治疗感染性心内膜炎的临床疗效。方法选取医院2014年11月-2015年10月348例感染性心内膜炎住院患者的临床资料,分析其感染病原菌分布与耐药性,用K-B纸片扩散法实施药敏检验,并依据美国临床实验室标准化委员会(NCCLS)标准对检查结果进行判断。结果 348份标本中有276份为阳性标本,阳性率为79.31%;共分离出294株病原菌,以革兰阳性菌为主,共209株占71.09%;嗜麦芽寡养单胞菌与大肠埃希菌对庆大霉素的耐药率为52.38%和52.78%,链球菌属对青霉素的耐药性极强,为94.44%;金黄色葡萄球菌对青霉素耐药性为92.31%。结论革兰阳性菌是感染性心内膜炎患者主要病原菌,临床治疗须依据其药敏试验的结果选择合理的抗菌药物。OBJECTIVE To investigate the pathogenic bacteria distribution and preventive measures of infective endocarditis in patients,so as to improve the clinical efficacy to infective endocarditis.METHODS A total of 348 cases of patients with infective endocarditis in hospital from Nov.2014 to Oct.2015 were selected to analyze the pathogenic bacteria distribution and drug resistance,using K-B disk diffusion method for drug sensitivity test,and based on the standard of National Committee for Clinical Laboratory Standards（NCCLS）to analyze the inspection results.RESULTS From the 348 specimens,a total of 276 were positive,and the positive rate was 79.31%.A total of 294 strains of pathogenic bacteria were isolated,mainly gram-positive bacteria,209 strains,accounting for71.09%.The drug resistant rates of Stenotrophomonas maltophilia and Escherichia coli to gentamicin were52.38% and 52.78%.The drug resistant rate of Streptococcus to penicillin was very high,94.44%,and Staphylococcus aureus to penicillin was 92.31%.CONCLUSION Gram positive bacteria are the main pathogens of infective endocarditis.Rational antimicrobial agents should be used in clinical treatment according to the results of the drug sensitivity test.

关 键 词：感染性心内膜炎 病原菌 抗菌药物 预防措施 

分 类 号：R542.41[医药卫生—心血管疾病]