胸腹水标本分离菌株及耐药性分析  

Study on strains isolated from the hydrothorax-peritoneum specimens and bacterial resistance

作　　者：刘贵育[1] 王中新[1] 

机构地区：[1]安徽医科大学第一附属医院检验科,安徽合肥230022

出　　处：《安徽医药》2008年第8期732-734,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的了解胸腹水标本中病原菌种类及其对抗菌药物的耐药情况，为临床合理用药提供参考。方法对我院2005年1月-2007年3月送检的胸腹水标本进行分离培养，并对分离菌用Micro Scan WalkAway-40全自动微生物鉴定仪进行鉴定及药敏试验。结果在1186份胸腹水标本中分离到病原菌共计186株，阳性检出率为15．7％，G^-菌占59．1％，G^-菌占29．0％，真菌占11．8％，主要以大肠埃希菌（20．4％）、铜绿假单胞菌（18．3％）、葡萄球菌（16．1％）、白假丝酵母菌（8．6％）、肠球菌（6．5％）、嗜麦芽窄食单胞菌（5．4％）为主。多数革兰阴性菌对三代头孢菌素的耐药率较高，对哌拉西林／他唑巴坦、阿米卡星、环丙沙星耐药率较低，大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌对亚安培南的耐药率分别为2．6％、5．9％、12．5％。嗜麦芽窄食单胞菌对多种抗菌药物耐药，但对复方新诺明耐药率较低（20％）。金黄色葡萄球菌耐甲氧西林的占40％，对万古霉素100％敏感。结论胸腹水标本中病原菌呈明显多样化。大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌对亚胺培南最敏感，嗜麦芽窄食单胞菌对复方新诺明最敏感，革兰阳性球菌对万古霉素最敏感。Aim To investigate the distribution and drug resistance of strains isolated from hydrothorax-peritoneum specimens in patients in the First Affiliated Hospital of Anhui Medical University from 2005 to 2007, in order to provide some references for clinical rational drug use. Methods The hydrothorax-peritoneum specimens were cultured and bacterial confirmatory and antibiotic susceptibility tests were carried out by MicroScan WalkAway-40 system with Combo Panel. Results 186 strains were isolated from hydrothorax-peritoneum specimens. The positive rate was 15.7%. Gram-negative bacteria accounted for 59.1% , among which Escherichia coli （ E. coli） was first （20.4%） ,then Ps aeruginosa （18.3%） and P. maltophilia（5.4% ）. Gram-positive bacteria were 29.0% and main bacteria were Staphylococcus（ 16.1% ） ,then Enterococci（6.5% ）. Fungus is 11.8% ,among which Candida albicans is 8.6%. More recently,gramnegative bacteria have high resistance rate to the third-generation cephalosporins, but Piperacillin/tazobactam or amikacin or ciprofloxacin was a relatively efficacious inhibitor to most strains. The resistance rate to Imipenem was 2.6% ,5.9% and 12.5% in Escherichia coli, Ps aeruginosa and Enterobacter cloacea respectively. The resistance rate to sulfamethoxazole was low （20%） in P. maltophilia, to which most drantibioticsugs was ineffective. Staphylococcus anreus, among which methicillin-resistant S. anreus （MRSA）were 40% ,were totally susceptive to vancomycin. Conclusion All kinds of bacteria and funfugs had been isolated from hydrothorax-peritoneum specimens. Escherichia coli and Ps aeruginosa and Enterobacter cloacae were susceptive to imipenem. P. maltophilia was susceptive to sulfamethoxazole and the multi-drug resistant gram positive coccus were susceptive to vancomycin.

关 键 词：胸腹水 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学] R442.5[医药卫生—临床医学]