摘要
目的研究心功能不全合并肺部感染的病原学特点,为临床提高心功能不全合并肺部感染的诊治水平提供参考。方法选取2010年10月-2012年10月入院治疗的心功能不全患者268例,对患者的痰液等呼吸道分泌物进行细菌培养和药敏试验,分析相关影响因素,对其进行病原学分析,并探讨相关的诊治对策,采用SPSS16.0进行统计分析。结果有基础疾病的患者发生感染215例,感染率为49.77%,无基础疾病的患者发生感染53例,感染率为20.75%;>70岁患者感染率为49.32%、60～70岁患者为40.48%、50～60岁患者为45.45%,<50岁患者为42.86%;268例患者做呼吸道分泌物培养378次,阳性302次,检出率79.89%,共检出病原菌408株,其中革兰阴性菌312株占76.47%,革兰阳性菌96株占23.53%;大肠埃希菌、肺炎克雷伯菌对头孢曲松、亚胺培南的敏感率>90.0%,铜绿假单胞菌、肺炎链球菌对亚胺培南的敏感率约90.0%。结论心功能不全合并肺部感染的发生率随着年龄升高有增加的趋势;病原菌以革兰阴性菌为主,并且病原菌对常见抗菌药物的耐药现象较为严重,临床上应及时调整用药方针,尽早发现及预防感染。
OBJECTIVE To study the distribution of pathogens causing pulmonary infections in cardiac insufficiency patients so as to improve the level of diagnosis and treatment of the cardiac insufficiency patients complicated with pulmonary infections.METHODS Totally 268cases of cardiac insufficiency,who were hospitalized from Oct 2010 through Oct 2012,were enrolled in the study,then the respiratory tract secretions such as sputum were sampled for bacterial culture and drug susceptibility testing,the related influencing factors were analyzed,the etiological analysis was performed,the corresponding countermeasures for diagnosis and treatment were proposed,and the statistical analysis was performed with the use of SPSS16.0 software.RESULTS The infections occurred in 215patients with underlying diseases,the incidence rate was 49.77%;the infections occurred in 53patients without underlying diseases,the incidence rate was 20.75%.The incidence of infections was 49.32% in the patients aged more than 70years old,40.48% in the patients aged between 60 and 70years old,45.45% in the patients aged between 50 and 60years old,42.86% in the patients aged less than 50years old.Of totally 378case-times of patients who were cultured for the respiratory tract secretions,302case-times were tested positive with the detection rate of 79.89%;a total of 408strains of pathogens have been isolated,among which there were 312（76.47%） strains of gram-negative bacteria and 96（23.53%）strains of gram-positive bacteria.The drug susceptibility rates of the Escherichia coli and Klebsiella pneumoniae to ceftriaxone and imipenem were more than 90.0%;the drug susceptibility rates of the Pseudomonas aeruginosa and Streptococcus pneumoniae to imipenem were around 90.0%.CONCLUSIONThe incidence of the pulmonary infections in the cardiac insufficiency patients is increased with the age.The gram-negative bacteria are dominant among the pathogens and are highly resistant to the commonly used antibiotics;it is necessary for the hospital to adjust the medication policies in a timely manner and to find and control the infections in early stage.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第1期122-124,共3页
Chinese Journal of Nosocomiology
基金
河南省卫生厅基金资助项目(200903127)
关键词
心功能不全
肺部感染
病原学分析
Cardiac insufficiency
Pulmonary infection
Etiological analysis
