慢性肺源性心脏病患者呼吸道感染的病原菌和耐药性分析

摘要

目的 慢性肺源性心脏病(CPHD)患者伴发呼吸道感染的病原菌及耐药情况.方法 回顾性调查分析252例CPHD患者呼吸道感染痰培养及药敏试验的临床资料.结果 共送痰培养检测406次,培养出病原菌364株,其中细菌278株,真菌86株;革兰阴性菌182株(65.5%),革兰阳性菌96株(35.5%).252例CPHD患者中有82例经验性治疗与药敏较吻合,感染控制不佳112例根据痰培养更换或联用抗生素后感染多数得到控制,有34例耐药明显,感染无法控制最终死亡,住院病死率为13.5%.结论 CPHD患者的呼吸道感染病原菌多为革兰阴性菌,常用抗生素耐药明显.应合理使用抗生素,防止药物滥用致细菌耐药引起难治性感染.%Objective To investigate the inforrmation of pathogenic bacteria and drug resistance in patients with chronic pulmonary heart disease ( CPHD ) and respiratory infection.Methods A retrospective review was adopted to analyze the results of sputum culture and susceptibility tests among 252 patients with CPHD and respiratory infection.Results 364 strains of pathogenic bacteria were found in 406 samples of sputum culture, including 278 strains of bacteria ( 65.5 ％ Gram-negative bacteria and 34.5 ％ Gram-positive bacteria) and 86 strains of fungus.Among 252 patients with CPHD,82 cases showed a drug sensitivity in good agreement with empirical treatment, 112 cases of poor infection control, the majority of which became under control after changing or combining use of antibiotics according to sputum culture,34 cases showed apparent drug resistance,infection could not be controlled which finally led to death, hospital mortality 13.5 ％.Conclusion The respiratory infection in patients with CPHD is mainly due to Gram-negative bacteria,which are resistant to common antibiotics.Clinicians should do more sputum cultures and rationally use antibiotics to avoid refractory infection induced by multiple drug resistance.