心脏移植术后呼吸机相关性肺炎病原体分析  

Pathogen Analysis of Ventilator-Associated Pneumonia After Heart Transplantation

作　　者：杜伟 马文君 张程[2] DU Wei;MA Wenjun;ZHANG Cheng(The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang,Guizhou,China 550001;Guizhou Provincial People's Hospital,Guiyang,Guizhou,China 550002)

机构地区：[1]贵州中医药大学第二附属医院,贵州贵阳550001 [2]贵州省人民医院,贵州贵阳550002

出　　处：《中国药业》2022年第S01期33-35,共3页China Pharmaceuticals

基　　金：中国医学科学院医学与健康科技创新工程项目[2020-I2M-2-003]。

摘　　要：目的探讨心脏移植术后呼吸机相关性肺炎病原体的菌种分布及感染因素。方法选取中山大学孙逸仙纪念医院心血管外科2019年1月至2021年9月接受心脏移植术的患者51例,其中心脏移植术后发生呼吸机相关性肺炎的患者27例,取痰培养筛查大于3次,记录并统计阳性病原菌的数据,并进行危险因素单因素分析及多因素Logistic回归分析。结果27例呼吸机相关性肺炎患者住院期间共送检痰培养170例次,检出病原菌128例次,以革兰阴性菌为主(占77.60%),其次为革兰阳性菌(占9.80%)、真菌(占12.60%)。常见感染因素为:深静脉置管(≥7 d)、抗菌药物使用种类(≥2种)、糖皮质激素使用(≥7 d)、免疫抑制剂使用(≥7 d)、肠外营养治疗(≥3 d)。讨论心脏移植术后患者呼吸机相关性肺炎的常见病原体菌群分布排名前3的病原菌为嗜麦芽假单胞菌、铜绿假单胞菌、白色念珠菌。其感染危险因素与其临床易感因素相符合。Objective To investigate the bacterial distribution and infection factors of ventilator-associated pneumonia after heart transplantation.Methods A total of 51 patients who underwent heart transplantation in cardiovascular surgery department of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 2019 to September 2021 were selected,including 27 patients with ventilator-associated pneumonia after heart transplantation.Sputum culture and screening were performed for more than 3 times,and the data of positive pathogenic bacteria were recorded and counted,and univariate analysis of risk factors was performed,Then the risk factors of ventilator-associated pneumonia infection after heart transplantation were analyzed by multivariate logistic regression.Results During the hospitalization period of 27 patients with ventilator-associated pneumonia,170 sputum cultures were sent for examination,and 128 pathogenic bacteria were detected.Gram-negative bacteria were the main ones(77.60%),followed by Gram-positive bacteria(9.80%)and fungi(12.60%).The common infection factors were deep venous catheterization(≥7 d),types of antibiotics(≥2),glucocorticoids(≥7 d),immunosuppressants(≥7 d),and parenteral nutrition treatment(≥3 D).Conclusion The common pathogens of ventilator-associated pneumonia in patients after heart transplantation were Pseudomonas maltophilia,Pseudomonas aeruginosa and Candida albicans.The risk factors of infection were consistent with the clinical susceptibility factors.

关 键 词：心脏移植 呼吸机相关性肺炎 病原体 相关性 

分 类 号：R974[医药卫生—药品]