感染性心内膜炎患者血培养病原菌分布特点和耐药性分析  

Analysis of the Distribution Characteristics and Resistance of Blood Culture Pathogens in Patients with Infectious Endocarditis

作　　者：孟凡兵 MENG Fan-bing(Department of Medicine Kaifeng Hospital of Traditional Chinese,Kaifeng 475000,Henan Province,China)

机构地区：[1]开封市中医院检验科,河南开封475000

出　　处：《罕少疾病杂志》2022年第8期34-35,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的分析感染性心内膜炎(IE)患者血培养病原菌分布特点和耐药性。方法选取2017年4月至2020年5月我院收治的IE患者106例,均采集血液标本,行病原菌培养鉴定和药敏试验,统计IE患者血培养病原菌分布特点和耐药性。结果103例IE患者中,共分离出132株病原菌,其中革兰阳性菌103株,占比78.03%(103/132),主要为金黄色葡萄球菌23.48%(31/132)、酿脓链球菌29.55%(39/132);革兰氏阴性菌24株,占比18.18%(24/132),主要为铜绿假单胞菌9.09%(12/132)、大肠埃希菌5.30%(7/132);真菌5株,占比3.79%(5/132),主要为近平滑假丝酵母2.27%(3/132)。酿脓链球菌对红霉素、四环素耐药率较高,对庆大霉素无耐药性;金黄色葡萄球菌对左氧氟沙星、红霉素耐药率较高;二者对万古霉素、利奈唑胺均无耐药性。铜绿假单胞菌对青霉素耐药率较高;大肠埃希菌对青霉素、头孢哌酮耐药率较高;二者对氨曲南、左氧氟沙星均无耐药性。结论IE患者多为革兰阳性菌感染,其次为革兰阴性菌,IE患者病原菌分布广泛,临床可根据患者实际情况及药敏试验结果合理选取抗菌药物。Objective To analyze the distribution and drug resistance of pathogenic bacteria in blood culture of patients with infective endocarditis(IE).Methods a total of 106 IE patients admitted to our hospital from April 2017 to May 2020 were selected,and blood samples were collected.Pathogen culture identification and drug sensitivity test were done.The distribution characteristics and drug resistance of pathogenic bacteria in blood culture of IE patients were counted.Results 132 strains of pathogenic bacteria were isolated from 103 IE patients.Gram-positive bacteria were 103 strains,accounting for 78.03%(103/132),mainly staphylococcus aureus 23.48%(31/132)and Streptococcus pyogenes 29.55%(39/132).There were 24 gram-negative strains,accounting for 18.18%(24/132),mainly pseudomonas aeruginosa 9.09%(12/132)and Escherichia coli 5.30%(7/132).There were 5 strains of fungi,accounting for 3.79%(5/132),and the main strain was Candida proxima(2.27%).Streptococcus pyogenes had higher drug resistance rates to erythromycin and tetracycline,but no drug resistance to gentamicin.The drug resistance rate of Staphylococcus aureus to levofloxacin and erythromycin was higher.There was no resistance to vancomycin and linezolid.The resistance rate of Pseudomonas aeruginosa to penicillin was higher.The resistance rate of Escherichia coli to penicillin and cefoperazone was higher.There was no resistance to tronam and levofloxacin.Conclusion Most IE patients are infected with Gram-positive bacteria,followed by gram-negative bacteria.Pathogenic bacteria in IE patients are widely distributed.Antibacterial drugs can be rationally selected according to the actual situation of patients and the results of drug sensitivity test.

关 键 词：感染性心内膜炎 病原菌分布 耐药性 

分 类 号：R542.41[医药卫生—心血管疾病]