摘要
目的分析感染性心内膜炎患者的血培养结果和病原菌耐药性。方法抽取2018年2月至2021年2月焦作煤业(集团)有限责任公司中央医院收治的感染性心内膜炎患者100例, 均行病原菌血培养和药敏试验。分析病原菌分布、主要病原菌对抗菌药物的耐药性和抗菌药物应用情况。结果 100份血培养标本中, 分离出病原菌106株。71株革兰阳性菌中链球菌39株, 金黄色葡萄球菌22株;30株革兰阴性菌中大肠埃希菌13株, 嗜麦芽寡养单胞菌8株;5株真菌中, 热带假丝醇母菌2株, 白色假丝醇母菌3株。链球菌、金黄色葡萄球菌对青霉素G耐药率达90%以上, 二者对利奈唑胺无耐药性, 且金黄色葡萄球菌对替考拉宁、克拉霉素耐药率为0。大肠埃希菌、嗜麦芽寡养单胞菌对庆大霉素耐药率达50%以上, 对美罗培南无耐药性。真菌对酮康唑、5-氟胞嘧啶耐药率均为40.00%(2/5), 对氟康唑、伏立康唑的耐药率均为20.00%(1/5)。100例患者中, 22例采用单一抗菌药物治疗, 78例采用≥2种抗菌药物联合治疗, 治疗后痊愈71例(71.00%)。结论感染性心内膜炎患者致病菌以革兰阳性菌为主, 其次为革兰阴性菌和真菌。不同致病菌对常用抗菌药物的耐药性存在很大差异, 临床可根据血培养和药敏试验结果, 选取2种及以上抗菌药物联合治疗。
Objective To analyze the blood culture results and drug resistance of pathogenic bacteria in patients with infective endocarditis.Methods One hundred patients with infective endocarditis who were admitted to Jiaozuo Coal Industry Central Hospital from February 2018 to February 2021 were selected,and the pathogenic bacteria blood culture and drug sensitivity test were performed.The distribution of pathogens,the drug resistance of main pathogens,and the application of antibacterial drugs were analyzed.Results The 106 strains of pathogenic bacteria were isolated from 100 blood samples,71 strains were gram-positive bacteria,including 39 strains of streptococcus and 22 strains of staphylococcus aureus;30 strains were gram-negative bacteria,including 13 strains of Escherichia coli,8 strains of Stenotrophomonas maltophilia;5 strains were fungi,including 2 strains of candida tropicalis and 3 strains of candida albicans.The resistance rates of streptococcus and staphylococcus aureus to penicillin G were as high as over 90%,and neither of them was resistant to linezolid,and the resistance rate of staphylococcus aureus to teicoplanin and clarithromycin was 0.The resistance rate of Escherichia coli and Stenotrophomonas maltophilia to gentamicin was more than 50%,and none of them were resistant to meropenem.The resistance rates of fungi to ketoconazole and 5-fluorocytosine were both 40.00%(2/5),and both 20.00%(1/5)to fluconazole and voriconazole.Among 100 patients,22 cases were treated with single antibacterial drug,78 cases were treated with≥2 kinds of antibacterial drugs,and 71 cases(71.00%)were cured after treatment.Conclusions The main pathogenic bacteria in patients with infective endocarditis are Gram-positive bacteria,followed by Gram-negative bacteria and fungi.There are significant differences in the resistance of different pathogenic bacteria to commonly used antimicrobials.In clinical practice,two or more antimicrobial agents with low drug resistance should selected according to the results of blood culture and drug sensitivity test.
作者
拓红晓
孙翔
Tuo Hongxiao;Sun Xiang(Department of Clinical Laboratory,Jiaozuo Coal Industry Central Hospital,Jiaozuo 451000,China;Department of Clinical Laboratory,Jiaozuo Second People’s Hospital,Jiaozuo 451000,China)
出处
《中国实用医刊》
2021年第20期11-13,共3页
Chinese Journal of Practical Medicine
关键词
病原菌
血培养
心内膜炎
Pathogenic bacteria
Blood culture
Endocarditis
作者简介
通信作者:拓红晓,Email:tuotuozi8812@163.com。
