论文部分内容阅读
目的探讨慢性心力衰竭患者合并社区获得性肺炎(community acquired pneumonia,CAP)的病原学分布特点及耐药性,为临床治疗提供理论依据。方法选取2011年4月—2014年10月116例慢性心力衰竭合并CAP患者,根据其病原学检查、细菌培养等结果,对病原菌构成及耐药性进行分析。结果感染组中年龄≥65岁、吸烟、合并糖尿病、慢性阻塞性肺疾病、高血压、长期卧床、滥用抗生素以及心功能Ⅲ~Ⅳ级的患者比例明显高于非感染组,两组比较差异均有统计学意义(均P<0.05)。116例中痰培养阳性71例,共检出病原菌15种86株,以革兰氏阴性菌为主,前5位病原菌分别为肺炎克雷伯杆菌(22.1%)、铜绿假单胞菌(11.6%)、鲍曼不动杆菌(10.5%)、奇异变形杆菌(8.1%)、真菌(8.1%)。结论慢性心力衰竭合并CAP患者以革兰氏阴性菌感染为主,临床表现多重耐药性,应引起重视。
Objective To explore the etiological distribution and drug resistance of community acquired pneumonia (CAP) in patients with chronic heart failure and to provide a theoretical basis for clinical treatment. Methods From April 2011 to October 2014, 116 patients with chronic heart failure complicated with CAP were enrolled in this study. Pathogenic bacteria composition and drug resistance were analyzed according to the etiological examination and bacterial culture. Results In the infection group, the proportion of patients aged 65 or older, smoking, diabetes mellitus, chronic obstructive pulmonary disease, hypertension, bedridden, abusing antibiotics and cardiac function grade Ⅲ ~ Ⅳ were significantly higher than those in non-infected group There was statistical significance (all P <0.05). Of the 116 cases sputum culture positive 71 cases, a total of 86 strains of pathogens were detected in 15 kinds of gram-negative bacteria, the first five pathogens were Klebsiella pneumoniae (22.1%), Pseudomonas aeruginosa (11.6 %), Acinetobacter baumannii (10.5%), Proteus mirabilis (8.1%), fungi (8.1%). Conclusion The patients with chronic heart failure complicated with CAP are mainly Gram-negative bacteria. Clinical manifestations of multi-drug resistance should be emphasized.