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目的研究心血管科住院患者感染病原菌分布及耐药性。方法选取兴隆县人民医院2012年5月—2014年5月心血管住院患者的送检痰液、血液、尿液等各类感染性标本所分离的病原菌,对病原菌的常规分离培养结果进行统计分析。结果本研究共分离出无重复病原菌270株,包括革兰阴性杆菌、革兰阳性杆菌以及真菌3种,分别为189株(70.0%)、64株(23.7%)、17株(6.3%)。其中肺炎克雷伯菌、鲍曼不动杆菌以及铜绿假单胞菌排在病原菌分离率的前3位。患者感染部位以呼吸道为主。肺炎克雷伯菌和大肠埃希菌对亚胺培南和阿米卡星具有高度的敏感性,对氨卡西林和第3代头孢菌则有明显的耐药性。同时鲍曼不动杆菌和铜绿假单胞菌对呋喃妥因和头孢唑林的耐药性较高,但对亚胺培南敏感性较高。结论心血管科患者医院感染的最为主要的病原菌是以肺炎克雷伯菌和鲍曼不动杆菌为主的革兰阴性杆菌,临床医学实践中,应保持对其耐药性的重视。
Objective To study the distribution and drug resistance of pathogenic bacteria in hospitalized patients with cardiovascular diseases. Methods From May 2012 to May 2014, Xinglong County People’s Hospital was selected for pathogenic bacteria isolated from infectious specimens of sputum, blood and urine from hospitalized patients, and the results of routine isolation and culture of pathogenic bacteria were statistically analyzed . Results A total of 270 unrelated pathogens were isolated, including Gram-negative bacilli, Gram-positive bacilli and fungi. They were 189 (70.0%), 64 (23.7%) and 17 (6.3%), respectively. Which Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa ranked in the top three pathogenic bacteria isolation rate. Patients with respiratory tract infection-based site. Klebsiella pneumoniae and Escherichia coli are highly sensitive to imipenem and amikacin, and have significant resistance to ampicillin and 3rd generation cephalosporins. At the same time, Acinetobacter baumannii and Pseudomonas aeruginosa were more resistant to nitrofurantoin and cefazolin, but were more sensitive to imipenem. Conclusions The most common pathogen of nosocomial infections in patients with cardiovascular diseases is Gram-negative bacilli, which are mainly Klebsiella pneumoniae and Acinetobacter baumannii. In clinical practice, the emphasis on drug resistance should be maintained.