【摘要】：目的探討老年冠心病患者醫(yī)院感染的病原菌分布及耐藥性。方法選取2014年12月-2016年2月醫(yī)院診治的216例老年冠心病醫(yī)院感染患者的資料進(jìn)行分析,采集患者痰液、血液及分泌物進(jìn)行病原菌培養(yǎng),采用最小抑菌濃度(MIC)法進(jìn)行體外藥敏試驗(yàn),分析老年冠心病醫(yī)院感染患者病原菌分布及耐藥性,根據(jù)病原菌耐藥性情況提出相應(yīng)的解決對(duì)策。結(jié)果老年冠心病患者醫(yī)院感染部位以呼吸道、尿路、胃腸道為主;216例老年冠心病醫(yī)院感染中共分離出234株病原菌,其中革蘭陰性菌138株占58.97%,以銅綠假單胞菌和大腸埃希菌為主;革蘭陽(yáng)性菌61株占26.07%,以金黃色葡萄球菌和表皮葡萄球菌為主;真菌35株占14.96%,以白色假絲酵母菌和曲霉菌屬為主;銅綠假單胞菌對(duì)氨芐西林/舒巴坦、哌拉西林、頭孢曲松及頭孢他啶耐藥率較高,均為78.26%;大腸埃希菌對(duì)阿莫西林/克拉維酸和哌拉西林耐藥率較高,均為81.48%。金黃色葡萄球菌和表皮葡萄球菌對(duì)環(huán)丙沙星和紅霉素耐藥率較高,分別為54.84%、51.61%和44.44%、55.56%。結(jié)論老年冠心病醫(yī)院感染病原菌主要以革蘭陰性菌為主,且耐藥性較高,應(yīng)選擇敏感抗菌藥物進(jìn)行治療,提高治愈率。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in elderly patients with coronary heart disease (CAD). Methods the data of 216 elderly patients with coronary heart disease (CAD) from December 2014 to February 2016 were analyzed. Sputum, blood and secretions were collected for pathogen culture. The drug sensitivity test in vitro was carried out by (MIC) method. The distribution and drug resistance of pathogenic bacteria in elderly patients with coronary heart disease (CAD) were analyzed, and the corresponding countermeasures were put forward according to the drug resistance of pathogenic bacteria. Results 234 strains of pathogenic bacteria were isolated from 216 elderly patients with coronary heart disease, including 138 strains of Gram-negative bacteria, mainly Pseudomonas aeruginosa and Escherichia coli, 61 strains of Gram-positive bacteria, mainly Staphylococcus aureus and Staphylococcus epidermidis, and 234 strains of pathogenic bacteria were isolated from 216 elderly patients with coronary heart disease, including respiratory tract, urinary tract and gastrointestinal tract, and 234 strains of pathogenic bacteria, including 138 strains of Gram-negative bacteria (58.97%) and 61 strains of Gram-positive bacteria (26.07%). 35 strains of fungi accounted for 14.96%, mainly Pseudomonas albicans and Aspergillus, Pseudomonas aeruginosa had higher resistance to ampicillin / sulbactam, piperacillin, ceftriaxone and ceftazidime, and Escherichia coli had higher resistance to amoxicillin / clavulanic acid and piperacillin, all of which were resistant to ampicillin / sulbactam, ceftriaxone and ceftazidime. The resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to ciprofloxacin and erythromycin were 54.84%, 51.61% and 44.44% respectively, and the resistance rates of Staphylococcus epidermidis to ciprofloxacin and erythromycin were 54.84%, 51.61% and 44.44% respectively. Conclusion Gram-negative bacteria are the main pathogens of hospital infection in elderly patients with coronary heart disease, and the drug resistance is high. Sensitive antibiotics should be selected for treatment to improve the cure rate.
【作者單位】： 重慶市中醫(yī)院呼吸科;
【基金】：重慶市衛(wèi)計(jì)委基金資助項(xiàng)目(2014-2-072)
【分類號(hào)】：R541.4

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