上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

感染性心内膜炎患者致病菌及其耐药性变迁

姚冬婷1，应春妹1，张纪伟2，汪雅萍1，杨海慧1，张灏旻1   

  1. 上海交通大学 医学院 1.附属仁济医院检验科， 上海 200127； 2.附属新华医院肛肠外科， 上海 200092
  • 出版日期:2013-08-28 发布日期:2013-09-16
  • 通讯作者: 应春妹, 电子信箱: ycmzh2012@163.com。
  • 作者简介:姚冬婷（1989—）， 女， 硕士生; 电子信箱: yaodongting@126.com。

Changes in distribution and drug resistance of pathogens in infective endocarditis

YAO Dong-ting1, YING Chun-mei1, ZHANG Ji-wei2, WANG Ya-ping1, YANG Hai-hui1, ZHANG Hao-min1   

  1. 1.Department of Clinical Laboratory, Renji Hospital，Shanghai Jiaotong University School of Medicine, Shanghai 200127, China; 2.Department of Anorectal Surgery, Xinhua Hospital， Shanghai Jiaotong University School of Medicine， Shanghai 200092, China
  • Online:2013-08-28 Published:2013-09-16

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摘要：

目的 分析感染性心内膜炎患者血培养分离菌的分布及其对常见抗菌药物的敏感性。方法 药敏试验采用Mueller-Hinton培养基，用K-B纸片扩散法进行。药敏结果采用WHONET 5.6软件进行分析。分析比较2005—2008年和2009—2012年感染性心内膜炎患者血培养分离菌致病菌的分布情况。结果 共分离出致病菌39株，其中草绿色链球菌23株（59.0%），是主要的致病菌。草绿色链球菌对青霉素和头孢曲松耐药率为13.0%，对红霉素和克林霉素耐药率为30.4%。葡萄球菌对青霉素的耐药率达81.8%，对苯唑西林的耐药率为54.5%。草绿色链球菌所占比例由2005—2008年间的66.7%下降至52.3%，而葡萄球菌所占比例由2005—2008年的11.1%上升至2009—2012年的42.9%。草绿色链球菌对各类常用抗菌药物敏感性均有下降趋势。结论 密切关注感染性心内膜炎致病菌的分布和耐药性变迁，可为临床合理选用抗菌药物提供依据。

关键词: 感染性心内膜炎, 致病菌, 耐药性

Abstract:

Objective To investigate the distribution and drug resistance of pathogens in blood culture of infective endocarditis patients. Methods The isolates were tested by K--B susceptibility method with Mueller-Hinton culture medium. The results of drug susceptibility test were analyzed by WHONET 5.6 software. The distribution of pathogens in blood culture of infective endocarditis patients between 2005 and 2008 and between 2009 and 2012 was analysed. Results Thirty-nine pathogens were isolated, among which Streptococcus viridans (n=23, 59.0%) was the most common pathogen. The resistance rate of Streptococcus viridans to penicillin and ceftriaxone was 13.0%, and that to erythromycin and clindamycin was 30.4%. The resistance rate of Staphylococcus to penicillin was 81.8%, and that to oxacillin was 54.5%. The proportion of Streptococcus viridans decreased from 66.7% between 2005 and 2008 to 52.3% between 2009 and 2012, and the proportion of Staphylococcus increased from 11.1% between 2005 and 2008 to 42.9% between 2009 and 2012. The resistance rate of Streptococcus viridans to all the common antibiotics exhibited a down trend. Conclusion The monitoring of changes of distribution and drug resistance of pathogens in infective endocarditis may guide the rational application of antibiotics.

Key words: infective endocarditis, pathogen, drug resistance