感染性心内膜炎病原菌分布及药敏试验结果分析  

Analysis of Distribution and Antibiotic Sensitivity of Microbiological Pathogens Associated with Infective Endocarditis

作　　者：刘培延 李园园[1] 潘希丁 LIU Peiyan;LI Yuanyuan;PAN Xiding(Department of Pharmacy,Nanjing First Hospital Nanjing Medical University,Nanjing 210006)

机构地区：[1]南京医科大学附属南京医院南京市第一医院药学部,南京210006

出　　处：《药学与临床研究》2018年第5期384-386,共3页Pharmaceutical and Clinical Research

摘　　要：对我院2013年1月至2017年12月期间收治的36例血培养阳性的感染性心内膜炎患者的病原菌分布及药敏试验结果进行回顾性分析,为临床经验性选用抗菌药物提供参考。36例血培养阳性患者共检出细菌38株,以革兰阳性球菌居多,包括链球菌属20株,葡萄球菌属14株,肠球菌属2株;革兰阴性菌少见。链球菌属对克林霉素、四环素耐药率较高,红霉素、氟喹诺酮类药物次之,对青霉素、氨苄西林、头孢噻肟敏感;葡萄球菌属中共检出苯唑西林9耐药株,青霉素12耐药株,耐苯唑西林及耐青霉素的菌株检出率较高;未见万古霉素、利奈唑胺、替加环素耐药阳性球菌。因此,在经验性治疗感染性心内膜炎时,青霉素类药物首选经验用药需谨慎,万古霉素可作为初始治疗效果欠佳或存在耐药菌感染患者的理想选择药物。This study analyzed retrospectively the distribution of pathogens isolated from blood cultures and the results of antimicrobial susceptibility testing in 36 patients with infective endocarditis admitted to Nanjing First Hospital from January 2013 to December 2017,so as to provide reference for the antibiotics selection in empirical anti-infection treatment.Thirty-eight strains of bacteria were cultured from blood samples,of which the most common were gram-positive coccus,including 20 strains of Streptococcus,14 strains of Staphylococcus and 2 strains of Enterococcus;gram-negative organisms were less common.Streptococcus were highly resistant to clindamycin and tetracycline,next to erythromycin and fluoroquinolone,while no penicillin,ampicillin or cefotaxime resistant strains were found.The resistance rates of Staphylococcus to penicillin or oxacillin were higher than to the others,including 9 oxacillin-resistant strains and 12 penicillin-resistant strains.No vancomycin,linezolid or tigecycline resistant gram-positive coccus were found.Therefore,we need to be careful about choosing penicillin as the drug of first choice for empirical treatment of infective endocarditis.Vancomycin would be an ideal choice for the patients with initial treatment failure and high risk factors of drug-resistant infections.

关 键 词：感染性心内膜炎 病原菌 药敏试验 

分 类 号：R915[医药卫生—微生物与生化药学]