哺乳期急性乳腺炎病原菌分布及耐药性分析  

Distribution of pathogens and drug resistance in patients with acute mastitis in lactation stage

作　　者：王宏[1] 蔡桂丰[1] 遇桂芳[2] 

机构地区：[1]珠海市妇幼保健院乳腺外科,广东珠海519000 [2]珠海市人民医院妇科,广东珠海519000

出　　处：《岭南现代临床外科》2008年第6期418-419,423,共3页Lingnan Modern Clinics in Surgery

基　　金：珠海卫生局课题项目编号:2006044

摘　　要：目的了解哺乳期急性乳腺炎患者病原菌分布特点及耐药状况,指导临床合理使用抗菌药物。方法收集哺乳期妇女局部穿刺抽出的脓性标本200份进行分离鉴定和药敏试验,用法国梅里埃公司生产的ATB鉴定系统进行细菌菌种鉴定,用K-B纸片扩散法做药敏试验。结果200份标本中共分离出98株病原菌,分离率为49%,其中葡萄球菌91株,占92.9%,链球菌4株,占4.1%,大肠杆菌3株,占3.1%。葡萄球菌对青霉素的耐药率为89.01%,对苯唑西林的敏感率为85.71%。对万古霉素、环丙沙星、莫西沙星、复方磺胺甲恶唑、庆大霉素、头孢唑啉、四环素、克林霉素的敏感率分别为100%、94.51%、87.91%、73.63%、63.74%、60.44%、59.34%、42.86%。结论哺乳期急性乳腺炎患者感染的主要病原菌为金黄色葡萄球菌,对青霉素的耐药率较高,但对苯唑西林敏感率较高,因此苯唑西林可以治疗大部分由葡萄球菌引起的乳腺炎。Objective To explore the distribution of pathogens and drug resistance in patients with acute mastitis during lactation. Methods 200 specimen isolated from patients with acute mastitis were identified with API identification system and the susceptibility test was detected by disk diffusion method. Results A total of 98/200 （49%） strains were isolated. The major pathogens were staphylococci （91,92.9%）, especially staphylococcus aureus. Streptococcus （4,4.1%） and bacillus coli （3,3.1%） were also detected. 89.01% of staphylococci was resistant to penicillin and 85.71% of it was sensitive to oxacillin. The sensitivity rate of staphylococci to other antibiotics such as vancomycin, ciprofloxacin, moxifloxaciu,SMZ, gentamycin, cefazolin, acheomycin and clindamycin were 100%, 94.51%, 87.91%, 73.63%, 63.74%, 60.44%, 59.34% and 42.86% respectively. Conclusion were The major pathogens in patients with acute mastitis in lactation stage is staphylococcus aureus and most of which are resistant to penicillin, while sensitive to oxacillin. Therefore, oxacillin can cure most acute mastitis in lactation stage and it should be the first choice to treat acute mastitis in lactation stage.

关 键 词：乳腺炎 金黄色葡萄球菌 细菌耐药性 

分 类 号：R655.8[医药卫生—外科学]