痰液标本病原菌培养及药敏试验在老年慢性心力衰竭合并肺部感染患者中的应用  

Application of Pathogen Culture in Sputum Samples and Drug Sensitivity Test in Elderly Patients with Chronic Heart Failure Complicated with Pulmonary Infection

作　　者：苏永发 SU Yongfa(Quanzhou First Hospital,Quanzhou 362002,China)

机构地区：[1]泉州市第一医院,福建泉州362002

出　　处：《中外医学研究》2023年第26期57-61,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨痰液标本病原菌培养及药敏试验在老年慢性心力衰竭合并肺部感染患者中的应用。方法:回顾性选取2020年5月—2022年8月泉州市第一医院收治的111例老年慢性心力衰竭合并肺部感染患者的资料。根据是否接受痰液标本病原菌培养及药敏试验将其分为对照组(55例)及观察组(56例)。观察组患者进行痰液标本病原菌培养及药敏试验。观察组根据痰液标本病原菌培养及药敏试验结果选择敏感抗生素进行抗菌治疗,对照组则以临床经验结合患者临床情况选择抗生素治疗。统计观察组痰液病原菌培养结果。分析鲍曼不动杆菌、表皮葡萄球菌的耐药情况。比较两组时间指标及不良反应。结果:观察组痰液病原菌培养中革兰阳性菌占比为37.5%,并以表皮葡萄球菌最常见,革兰阴性菌占比为55.4%,以鲍曼不动杆菌最常见。鲍曼不动杆菌对头孢他啶、庆大霉素、头孢噻肟、磺胺甲恶唑和环丙沙星的耐药率均超过90.0%,对亚胺培南的耐药率仅为4.8%,对美罗培南无耐药性。表皮葡萄球菌对磺胺甲恶唑、氨苄西林、红霉素、罗红霉素和青霉素G耐药率均较高,超过60.0%,对左氧氟沙星和环丙沙星相对敏感,对万古霉素和替考拉宁十分敏感,无耐药发生。观察组使用呼吸机时间、绝对卧床时间和住院时间均显著短于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:慢性心力衰竭合并肺部感染患者以鲍曼不动杆菌和表皮葡萄球菌感染多见,及时接受痰液标本病原菌培养及药敏试验,可提高临床治疗效果,减少抗生素不良反应。Objective:To explore the application of pathogen culture in sputum samples and drug sensitivity test in elderly patients with chronic heart failure complicated with pulmonary infection.Method:The data of 111 elderly patients with chronic heart failure complicated with pulmonary infection admitted to Quanzhou First Hospital from May 2020 to August 2022 were retrospectively selected.The patients were divided into control group(55 cases)and observation group(56 cases)according to whether they received pathogen culture in sputum samples and drug sensitivity test.Pathogen culture in sputum samples and drug sensitivity test was performed in the observation group.The observation group selected sensitive antibiotics for antimicrobial treatment according to the results of pathogen culture in sputum samples and drug sensitivity test,while the control group selected antibiotics treatment according to clinical experience and clinical conditions.The culture results of pathogenic bacteria in sputum of observation group were analyzed.The drug resistance condition of Acinetobacter baumannii and Staphylococcus epidermidis were analyzed.Time indexes and adverse reactions were compared between the two groups.Result:In the observation group,Gram-positive bacteria accounted for 37.5%,and Staphylococcus epidermidis was the most common,Gram-negative bacteria accounted for 55.4%,and Acinetobacter baumannii was the most common in the observation group sputum pathogen culture.The drug resistance rate of Acinetobacter baumannii to Ceftazidime,Gentamicin,Cefotaxime,Sulfamethoxazole and Ciprofloxacin exceeded 90.0%,while the resistance rate to Imipenem was only 4.8%,and to Meropenem was not resistant drug.The resistance rate of Staphylococcus Epidermidis to Sulfamethoxazole,Ampicillin,Erythromycin,Roxithromycin and Penicillin G was higher,exceed 60.0%.It was relative sensitive to Levofloxacin and Ciprofloxacin,and very sensitive to Vancomycin and Teicoplanin,and no drug resistance occurred.The time of ventilator use,absolute bed time and hos

关 键 词：痰液 病原菌培养 药敏试验 慢性心力衰竭 肺部感染 抗菌治疗 

分 类 号：R541.6[医药卫生—心血管疾病] R563.1[医药卫生—内科学]