摘要
目的了解心脏手术后肺部感染患者的病原菌分布及耐药情况,为临床合理应用抗菌药物提供依据。方法分析2012年1月—2017年6月本院心脏手术后肺部感染患者痰标本分离得到的病原菌和药敏结果。结果分离得到237株病原菌,其中革兰阴性菌153株(64.56%),排在前5位的分别为鲍曼不动杆菌、嗜麦芽窄食单胞菌、肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌。革兰阳性菌20株(8.44%),主要为肺炎链球菌和金黄色葡萄球菌。真菌64株(27.00%),主要为白假丝酵母菌、热带假丝酵母菌和克柔假丝酵母菌。药敏结果显示:革兰阴性菌对大多数药物的耐药率较高,但对头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率较低;肺炎链球菌和金黄色葡萄球菌除对利福平、万古霉素、利奈唑胺和莫西沙星没有出现耐药菌株外,对其他药物均出现不同程度的耐药。真菌的耐药率较低,但氟康唑对克柔假丝酵母菌无活性。结论心脏术后肺部感染的病原菌以革兰阴性菌为主,且耐药现象较为严重,但其他病原菌感染也不容忽视。临床应根据药敏结果合理使用抗菌药物,以延缓耐药菌的产生。
Objective To investigate the pathogen distribution characteristics and drug resistance in pulmonary infection patients after cardiosurgery, and to provide reference for the rational use of antibacterials in clinical practice. Methods Pathogen distribution characteristics and drug sensitivity tests of sputum samples isolated from patients with pulmonary infection after cardiosurgery from January 2012 to June 2017 were analyzed. Results Totally 237 pathogenic bacteria were isolated. Totally 153 strains were gram-negative bacteria （64.56%）, with the top 5 being Acinetobacter baumannii, Stenotrophomonas maltophilia, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli; Another 20 strains were gram-positive bacteria （8.44%）, mainly Streptococcus pneumonia and Staphylococcus aureus; another 64 strains were fungus （27.00%）, mainly Candida albicans, Candida tropicalis and Candida krusei. Drug sensitivity tests showed that gram-negative bacteria had a high resistance rate to most drugs except for cefoperazone/shubatan and piperacillin/tazobactam. Streptococcus pneumoniae and Staphylococcus aureus did not appear resistant to rifampin, vancomycin, linezolid and moxifloxacin, but they showed different levels of resistance to other drugs. The resistance rate of fungi was low, but fluconazole was not actively against Candida krusei. Conclusion Gram-negative bacteria are the major pathogens in pulmonary infection patients after cardiosurgery with serious resistance. Other pathogen infections should not be besides except gram-negative bacteria. Antibacterials should be rationally used according to the drug sensitivity tests in order to delay the emergence of drug-resistant bacteria.
作者
李健哲
薛薇
陈清洁
余术宜
LI Jian-zhe1, XUE Wei1, CHEN Qing-jie1, YU Shu-yi2.(1. Department of Pharmacy, RuikangHospital, Guangxi University of Chinese Medicine, Nanning 530011; 2. Advanced Research Study （Modern Analysis and Testing Center）, Center South University, Changsha 410000)
出处
《中南药学》
CAS
2018年第3期419-423,共5页
Central South Pharmacy
基金
国家自然科学基金(No.81460613)
广西自然科学基金(No.2015GXNSFAA139115
2013GXNSFBA019126)
广西卫生厅资助项目(No.Z2013206)
广西中医药管理局资助项目(No.GZZC14-36)
关键词
心脏手术
肺部感染
病原菌
耐药性
cardiosurgery
pulmonary infection
pathogen
drug resistance
