摘要
目的探讨冠心病患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后并发感染病原菌分布特征及相关危险因素,为预防感染提供参考依据。方法回顾性选取本院心血管内科收治的45例冠心病PCI术后并发感染者为研究对象,同时选取同期45例未并发感染者为对照组。调取两组患者临床资料,采用Logistic回归分析感染相关危险因素。采集患者感染部位样本经培养分离后,进行病原菌鉴定,K-B纸片扩散法进行药敏试验。采集患者静脉血,离心处理后取上清液,采用酶联免疫吸附法测定血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平。采用Gensini评分系统对患者冠动脉狭窄程度进行定量评价,分析患者血清IL-6、CRP水平与Gensini评分的相关性。结果45例冠心病PCI术后并发感染患者,其中20例为上呼吸道感染,12例为下呼吸道感染,6例为泌尿系统感,5例为消化系统感染,2例为穿刺部位感染。共检出病原菌48株。革兰阴性菌18株,包括大肠埃希菌7株,肺炎克雷伯菌5株,铜绿假单胞菌3株,鲍曼不动杆菌2株,阴沟肠杆菌1株。革兰阳性菌23株,包括肺炎链球菌8株,金黄色葡萄球菌7株,表皮葡萄球菌5株,粪肠球菌2株,屎肠球菌1株。真菌7株,均为白色假丝酵母菌。18株革兰阴性菌对庆大霉素、左氧氟沙星、环丙沙星的耐药率高于50%,对亚胺培南、美罗培南、莫西沙星的耐药率低于20%,未产生对阿米卡星的耐药株。23株革兰阳性菌对青霉素、红霉素、妥布霉素、庆大霉素、左氧氟沙星、环丙沙星的耐药率高于50%,未产生对万古霉素的耐药株。7株真菌对氟胞嘧啶100%耐药,对伊曲康唑、咪康唑的耐药率低于20%。感染组患者Gensini评分为(66.73±10.06)分,血清IL-6为(16.93±3.21)pg/mL,血清CRP为(25.60±2.67)mg/L,对照组患者Gensini评分为(44.73±6.43)分,血清IL-6为(10.47±2.31)pg/mL,血清CRP为(17.22±2.63)mg/L,两组患者对比差异具有
Objective To explore the distribution characteristics of pathogenic bacteria and related risk factors in postoperative complications of percutaneous coronary intervention(PCI)in patients with coronary heart disease,for providing reference for the prevention of infection.Methods The 45patients with concurrent infections after coronary heart disease PCI admitted to the Cardiovascular Department of our hospital were retrospective selected as the study subjects,and 45patients without concurrent infections the same period were selected as the control group.The clinical data were retrieved from two groups of patients and the relevant risk factors for postoperative complications in coronary heart disease patients undergoing PCI were analyzed by logistic regression.After collecting samples from infected areas of patients and culturing and isolating them,pathogen identification was carried out,and drug sensitivity testing was conducted by the K-B paper diffusion method.The venous blood was collected from patients,after centrifuging the supernatant were and collected,and the serum levels of interleukin-6(IL-6)and C-reactive protein(CRP)were measured by enzyme-linked immunosorbent assay.The degree of coronary artery stenosis in patients was quantitatively evaluated by the Gensini scoring system,and the correlation between serum IL-6,CRP levels and the Gensini score were analyzed.Results There were 45patients with concurrent infections after PCI for coronary heart disease,including 20cases of upper respiratory tract infections,12cases of lower respiratory tract infections,6cases of urinary system infections,5 cases of digestive system infections,and 2cases of puncture site infections.A total of 48strains of pathogenic bacteria were detected.There were 18strains of Gram negative bacteria,including 7strains of Escherichia coli,5strains of Klebsiella pneumoniae,3strains of Pseudomonas aeruginosa,2strains of Acinetobacter baumannii,and 1strain of Enterobacter cloacae.There were 23strains of Gram positive bacteria,including 8stra
作者
白晓瑜
郑明奇
郭婷
彭珊珊
鲁晓宁
肖怡
戴祎迪
张君
BAI Xiaoyu;ZHENG Minqi;GUO Ting;PENG Shanshan;LU Xiaoning;XIAO Yi;DAI Yidi;ZAHNG Jun(The First Hospital of Hebei Medical University,Shijiazhuang050031,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2024年第4期477-481,共5页
Journal of Pathogen Biology
关键词
冠心病
经皮冠状动脉介入
相关因素
病原菌
coronary heart disease
percutaneous coronary intervention
related factors
pathogenic bacteria
