分析心脏移植受者微生物标本送检、分离菌分布及其耐药情况，为临床对心脏移植受者感染的预防与抗菌治疗提供依据。

回顾性分析中国医学科学院阜外医院2019年1月至2024年12月收治的508例心脏移植受者送检的各类微生物标本(1 322株初始分离菌株)，剔除同一受者相同部位的重复菌株后，共纳入非重复菌株517株进行分析。采用WHONET 5.6软件，根据美国临床和实验室标准化协会M100第34版(2024年)标准，分析分离菌的体外药敏试验数据。

517株分离菌株中细菌483株、真菌34株，以革兰阴性杆菌为主(73.3%，379/517)，分离菌株前5位依次是肺炎克雷伯菌(32.1%，166/517)、大肠埃希菌(9.9%，51/517)、铜绿假单胞菌(8.1%，42/517)、屎肠球菌(6.4%，33/517)和阴沟肠杆菌(5.2%，27/517)。分离菌在各类标本中的分布以呼吸道标本为主(60.8%)，其后依次是尿液(17.3%)、血液(7.1% )和分泌物标本(5.5%)。碳青霉烯耐药肺炎克雷伯菌(CRKP)、碳青霉烯耐药铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌检出率分别为10.8%、7.1%和6.7%，未检出耐万古霉素肠球菌。

心脏移植受者送检标本以呼吸道标本为主，分离菌中以革兰阴性杆菌为主，整体耐药率低于全国水平，但CRKP检出率呈上升趋势，需引起高度重视。

To analyze microbial specimen submissions, distribution of isolated pathogens and their antimicrobial resistance among heart transplant patients and provide evidence-based guidance for infection prevention and antimicrobial therapy in these patients.

A retrospective analysis was performed on various microbial specimens collected from 508 heart transplant recipients admitted to Fuwai Hospital, Chinese Academy of Medical Sciences, from January 2019 to December 2024. A total of 1 322 primary isolates were initially obtained. After excluding duplicate isolates from the same anatomical site of an individual recipient, 517 nonduplicate isolates were included for analysis. WHONET 5.6 software was used to analyze invitro antimicrobial susceptibility test results in accordance with the Clinical and Laboratory Standards Institute (CLSI) M100S34 (2024).

Among the 517 isolates, 483 were bacteria and 34 were fungi. Gramnegative bacteria predominated, accounting for 73.3% (379/517). The top five isolated pathogens were Klebsiella pneumoniae (32.1%, 166/517), Escherichia coli (9.9%, 51/517), Pseudomonas aeruginosa (8.1%, 42/517), Enterococcus faecium (6.4%, 33/517), and Enterobacter cloacae (5.2%, 27/517). Specimenbased distribution showed respiratory specimens constituted the largest proportion (60.8%), followed by urine specimens (17.3%), blood specimens (7.1%), and secretion specimens (5.5%). The detection rates of carbapenemresistant Klebsiella pneumoniae (CRKP), carbapenemresistant Pseudomonas aeruginosa, and methicillinresistant Staphylococcus aureus were 10.8%, 7.1% and 6.7%, respectively. No vancomycinresistant enterococci were detected.

Respiratory specimens dominate the submitted samples from heart transplant recipients. Gramnegative bacilli are the predominant isolates. Overall antimicrobial resistance rates are lower than the national average resistance level in China. Nevertheless, the detection rate of CRKP shows an upward trend, which warrants close clinical attention.