感染性心内膜炎患者血培养病原菌及其耐药性剖析.docVIP

感染性心内膜炎患者血培养病原菌及其耐药性剖析 　　【摘要】 目的：分析感染性心内膜炎患者血培养病原菌及其耐药性，为临床提供参考。方法：通过对52例2003年9月-2013年9月本院收治的感染性心内膜炎患者进行血培养实验和病原菌耐药性实验，分析感染性心内膜炎患者血培养病原菌及其耐药性。结果：52例患者共筛选出32株病原菌，感染率为61.54%，其中革兰阳性菌株28株，占87.50%，主要为金黄色葡萄球菌、草绿色链球菌、粪肠球菌、牛链球菌、口腔链球菌和表皮葡萄球菌，革兰阳性菌对环丙沙星和庆大霉素耐药性较强，对万古霉素耐药性较差；革兰阴性菌4株，占12.50%，主要为铜绿假单胞、产气肠杆菌和大肠埃希菌，革兰阴性菌对庆大霉素耐药性较强，对头孢哌酮和环丙沙星耐药性较差。结论：金黄色葡萄球菌和草绿色链球菌是感染性心内膜炎的主要致病菌，而这两株菌对万古霉素的耐药性均较差，所以临床上可以用万古霉素作为预防和治疗感染性心内膜炎的主要抗生素，这对临床治疗感染性心内膜炎有重要的指导意义。 　　【关键词】 感染性心内膜炎； 病原菌； 血培养； 耐药性 　　【Abstract】 Objective：To analyze pathogenic bacteria and drug resistance in blood of patients with infective endocarditis， and to provide reference for clinical.Method：52 cases of patients with infective endocarditis were obtained from 2003 September to 2013 September in our hospital， which were used to do pathogen resistance experiment and blood culture experiment， and the endocarditis culture and drug resistance of pathogens were analyzed.Result： 32 strains of pathogenic bacteria were screened from 52 patients， the infection rate was 61.54%， of which 28 strains were gram positive strains， accounting for 87.50%， mainly included Staphylococcus aureus， Streptococcus viridans， Enterococcus faecalis， Streptococcus bovis， oral Streptococcus and Staphylococcus epidermidis，the resistance of gram positive bacteria to ciprofloxacin and gentamicin was strong，but the resistance to vancomycin was poor. Gram negative bacteria were 4， accounted for 12.50%， mainly included Pseudomonas， Enterobacter aerogenes and Escherichia coli，the resistance of gram negative bacteria to gentamicin was strong， but the resistance to cefoperazone and ciprofloxacin was poor. Conclusion：Staphylococcus aureus and Streptococcus viridans were the main pathogens of infective endocarditis， and drug resistance of two strains of bacteria to vancomycin were poor，so the clinical prevention and treatment with vancomycin as the main anti-infective endocarditis， which has an important significance for the clinical treatment of infective endocar