摘要
目的收集心血管疾病合并肺炎的老年患者资料,对感染病原菌分布及耐药情况进行分析,为临床治疗提供科学的参考依据。方法收集心血管疾病合并肺炎的老年患者126例,采集痰液标本,采用K-B纸片扩散法测定细菌耐受性。采用煮沸法提取肺炎克雷伯菌DNA,并检测毒力基因和耐药基因。结果126份样本中共计分离出102株病原菌,分离率80.95%。其中革兰阴性菌67株,占65.69%,以肺炎克雷伯菌和大肠埃希菌为主;革兰阳性菌30株,占29.41%,以肺炎链球菌为主;真菌4株,占3.92%,全部为假丝酵母菌。革兰阳性菌对头孢唑林、头孢曲松、四环素、红霉素、庆大霉素、环丙沙星、加替沙星、利福平、替考拉宁和万古霉素耐药率为70.97%、64.52%、74.19%、80.65%、74.19%、48.39%、12.90%、6.45%、0.00%和0.00%。革兰阴性菌对庆大霉素、哌拉西林、哌拉西林/他唑巴坦、四环素、头孢他啶、环丙沙星、阿米卡星和亚胺培南的耐药率为70.15%、76.12%、14.93%、62.69%、43.28%、56.72%、22.39%和13.43%。肺炎克雷伯菌对庆大霉素、哌拉西林、哌拉西林/他唑巴坦、四环素、头孢他啶、环丙沙星、阿米卡星和亚胺培南的耐药率为80.00%、80.00%、13.33%、53.33%、50.00%、60.00%、20.00%和13.33%。30株肺炎克雷伯菌中共有9株检出毒力基因,其中3株为单一毒力基因,其他6株含两种以上毒力基因。K1、K2、K5、K20、magA、rmpA和wcaG毒力基因携带情况为3、2、0、0、3、3和4株,携带率为10.00%、6.67%、0.00%、0.00%、10.00%、10.00%和13.33%。30株肺炎克雷伯菌携带CTX-M-1、CTX-M-2、CTX-M-8、CTX-M-9、IMP、VIM、TEM和SHV株数为2、0、1、4、2、2、3和0株,携带率为6.67%、0.00%、3.23%、13.33%、6.67%、6.67%、10.00%和0.00%。结论本次研究中肺炎克雷伯菌是主要致病菌,肺炎克雷伯菌和大肠埃希菌对庆大霉素、哌拉西林耐药程度最高。肺炎链球菌对红霉素和四环素同时耐药�
Objectives The data of elderly patients with cardiovascular disease complicated with pneumonia were collected,and to provide scientific reference for clinical treatment by investigating the distribution and drug resistance of pathogenic bacteria.Methods 126 elderly patients with cardiovascular disease and pneumonia were collected,sputum samples were collected,bacterial tolerance was measured by K-B disk diffusion method.The DNA of Klebsiella pneumoniae was extracted by boiling method,and the virulence genes and drug resistance genes were detected.Results A total of 102 pathogenic bacteria were isolated from 126 samples,the isolation rate was 80.95%.Among them,67 were Gram-negative bacteria,accounting for 65.69%,mainly Klebsiella pneumoniae and Escherichia coli;30 were Gram-positive bacteria,accounting for 29.41%,mainly Streptococcus pneumoniae;4 were fungi,accounting for 3.92%,all of them were Candida.The resistance rates of Gram-positive bacteria to cefazolin,ceftriaxone,tetracycline,erythromycin,gentamycin,ciprofloxacin,gatifloxacin,rifampin,teicoplanin and vancomycin were 70.97%,64.52%,74.19%,80.65%,74.19%,48.39%,12.90%,6.45%,0.00%and 0.00%,respectively.The resistance rates of gram negative bacteria to gentamicin,piperacillin,piperacillin tazobactam,tetracycline,ceftazidime,ciprofloxacin,amikacin and imipenem were 70.15%,76.12%,14.93%,62.69%,43.28%,56.72%,22.39%and 13.43%,respectively.The resistance rates of K.pneumoniae to gentamicin,piperacillin,piperacillin tazobactam,tetracycline,ceftazidime,ciprofloxacin,amikacin and imipenem were 80.00%,80.00%,13.33%,53.33%,50.00%,60.00%,20.00%and 13.33%,respectively.9 strains detected virulence genes,3 of which were single virulence genes,and the other 6 strains contained more than two virulence genes,in 30 K.pneumoniae.The carrying rate of virulence genes of K1,K2,K5,K20,Maga,rmpA and wcaG was 10.00%,6.67%,0.00%,0.00%,0.00%,10.00%,10.00%and 13.33%respectively.The number of CTX-M-1,CTX-M-2,CTX-M-8,CTX-M-9,IMP,VIM,TEM and SHV carried by 30 strains of K.pneumoniae was 2,0
作者
朱蕾
瑞云
乌仁高娃
ZHU Lei;DUAN Yun;WU Rengaowa(School of Basic Medical Sciences,Chifeng University,Chifeng 024000,Inner Mongolia,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2020年第6期729-732,736,共5页
Journal of Pathogen Biology
关键词
心血管疾病
肺炎
病原菌
耐药分析
cardiovascular disease
pneumonia
pathogenic bacteria
analysis of drug resistance
