72例开胸心脏手术患者术后胸骨骨髓炎感染病原菌的分布及其耐药性分析  

Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in 72 Patients with Sternal Osteomyelitis after Heart Surgery

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作  者:吴艳[1] 郭兵兵[1] 黄白艳 WU Yan;GUO Bing-bing;HUANG Bai-yan(The Seventh People's Hospital of Zhengzhou,Zhengzhou 450016,China)

机构地区:[1]郑州市第七人民医院,郑州450016

出  处:《抗感染药学》2021年第10期1445-1448,共4页Anti-infection Pharmacy

摘  要:目的:分析开胸心脏手术患者术后胸骨骨髓炎感染病原菌的分布及其耐药特点。方法:选取郑州市第七人民医院2018年3月—2020年10月收治的行开胸心脏手术术后致胸骨骨髓炎患者72例病历资料,统计其血液标本的病原菌培养及药敏试验结果,分析其病原菌的分布及其对抗菌药物的耐药特点。结果:72例开胸心脏手术后胸骨骨髓炎患者血液标本中,分离出81株病原菌,其中革兰阳性菌47株(占58.02%,以金黄色葡萄球菌、表皮葡萄球菌为主)、革兰阴性菌34株(占41.98%,以铜绿假单胞菌、肺炎克雷伯菌为主);药敏结果发现:金黄色葡萄球菌对青霉素、克林霉素、红霉素耐药率较高,对利福平、庆大霉素耐药率较低;表皮葡萄球菌对青霉素、苯唑西林、红霉素耐药率较高,对利福平耐药率较低;铜绿假单胞菌对头孢曲松、头孢哌酮耐药率较高,对妥布霉素、头孢他啶耐药率较低;肺炎克雷伯菌对氨苄西林耐药率较高,对头孢哌酮、亚胺培南耐药率较低。结论:开胸心脏手术后胸骨骨髓炎患者主要感染菌群为革兰阳性菌,其中又以金黄色葡萄球菌、表皮葡萄球菌菌株为主,临床应依据药敏结果选用抗菌药物,以确保其疗效和预后的康复。Objective: To analyze the distribution and drug resistance of pathogenic bacteria in 72 patients with sternal osteomyelitis after heart surgery. Methods: The medical records of 72 patients with sternal osteomyelitis after heart surgery admitted to the Seventh People’s Hospital of Zhengzhou from March 2018 to October 2020 were selected.The results of pathogen culture and drug sensitivity test of their blood samples were analyzed, and the distribution of pathogens and their antimicrobial resistance characteristics were analyzed. Results: 81 strains of pathogenic bacteria were isolated from the blood samples of 72 patients with sternal osteomyelitis after open-heart surgery, including 47 strains of Gram-positive bacteria(58.02%, mainly Staphylococcus aureus and Staphylococcus epidermidis) and 34 strains of Gram-negative bacteria(41.98%, mainly Pseudomonas aeruginosa and Klebsiella pneumoniae). Drug sensitivity results showed that Staphylococcus aureus had higher drug resistance to penicillin, clindamycin and erythromycin, but lower drug resistance to rifampicin and gentamicin. The drug resistance rate of Staphylococcus epidermis to penicillin, oxacillin and erythromycin was higher than that to rifampicin. The drug resistance rate of Pseudomonas aeruginosa to ceftriaxone and cefoperazone was higher, but the drug resistance rate to tobramycin and ceftazidime was lower. The drug resistance rate of Klebsiella pneumoniae was higher to ampicillin, but lower to cefoperazone and imipenem. Conclusion: After Thoracotomy surgery the patients with sternum osteomyelitis are mainly infected with Gram-positive bacteria, in which Staphylococcus aureus and Staphylococcus epidermidis are the main strains. Antibacterial drugs should be selected based on the drug sensitivity results in clinic to ensure the curative effect and prognosis of recovery.

关 键 词:开胸心脏手术 胸骨骨髓炎 病原菌 耐药性 

分 类 号:R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]

 

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