目的 分析慢性心力衰竭患者伴发下呼吸道感染的病原菌及耐药菌情况.方法 回顾性分析126例慢性心力衰竭患者下呼吸道感染痰培养及药敏试验的临床资料,对其病原菌分布及耐药情况进行统计分析.结果 在203次痰培养检测中,培养出病原菌182株,包括细菌139株和真菌43株.139株细菌中包括革兰阳性球菌48株(35.5％)和革兰阴性杆菌91株(65.5％).126例慢性心力衰竭患者中根据经验治疗的有41例与药敏结果相吻合,感染控制差的68例患者根据痰培养结果更换或联合用抗生素后多数控制了感染,另有17例耐药明显,最终死于严重感染,住院病死率13.5％.结论 慢性心力衰竭患者下呼吸道感染病菌多为革兰阴性菌,对常用抗生素有明显耐药性.合理使用抗生素,防止药物滥用是预防细菌耐药的关键.%Objective To investigate the information of pathogenic bacteria and drug resistance in patients with chronic heart failure and lower respiratory infections. Methods A retrospective review was adopted to analyze the results of sputum culture and susceptibility tests among 126 patients with chronic heart failure and lower respiratory infections. The pathogen distribution and drug resistance was analyzed statistically. Results Of 203 samples of sputum culture, 182 strains of pathogenic bacteria were found, including 139 strains of bacteria that consisted of 65.5% (91/139) Gram-negative bacteria and 34.5% (48/139) Gram-positive bacteria, and 43 strains of fungus. In 126 patients with chronic heart failure. 41 patients had the drug sensitivity in good agreement with empirical treatment, and 68 patients had poor infection controlled according to sputum culture or in combination with antibiotics after the replacement of the majority of infections under control, and 17 cases were dead as apparent drug resistance and infection without control, and the hospital mortality was 13.5%. Conclusion The lower respiratory infections in patients with chronic heart failure are mostly due to Gram-negative bacteria, and antimicrobial resistance was commonly evident. Rational use of antibiotics and avoiding drug abuse are the key for preventing bacterial resistance.
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