肝硬化并发自发性腹膜炎患者腹水感染的细菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing ascites infections in cirrhosis patients complicated with spontaneous bacterial peritonitis

作　　者：章文华[1] 陈鉴[1] 程海燕[1] 沈哲[1] 

机构地区：[1]浙江省绍兴第二医院消化内科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2013年第24期6144-6146,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医学会临床科研基金项目(2011ZYC-A90)

摘　　要：目的分析肝硬化并发自发性腹膜炎患者腹水感染的细菌分布及耐药性,为临床感染控制及抗菌药物的应用提供依据。方法选取医院2010年2月-2013年2月收治的肝硬化并发自发性腹膜炎腹水感染患者86例临床资料,对腹水进行细菌培养基药敏试验,采用WHO推荐的WHONET5.3软件对数据进行统计分析。结果腹水感染革兰阴性杆菌包括大肠埃希菌46株占53.49%、肺炎克雷伯菌9株占10.47%、铜绿假单胞菌8株占9.3%、结核分枝杆菌6株占6.98%;革兰阳性球菌包括粪肠球菌8株占9.3%、表皮葡萄球菌8株占9.3%、其他细菌1例占1.16%;大肠埃希菌对氨苄西林、头孢噻吩及环丙沙星均有较高的耐药性,对头孢吡肟、头孢哌酮、阿米卡星耐药性较低。结论肝硬化并发自发性腹膜炎腹水感染细菌主要以大肠埃希菌为主,临床根据药敏试验合理选用敏感抗菌药物对治疗具有重要作用。OBJECTIVE To analyze the distribution and drug resistance of the pathogens causing ascites infections in cirrhosis patients complicated with spontaneous bacterial peritonitis so as to provide guidance for the clinical use of antibiotics. METHODS The clinical data of 86 cases of liver cirrhosis patients complicated with spontaneous bacterial peritonitis ascites infection who were treated in the hospital from Feb 2010 to Feb 2018 were selected, then the ascites media were cultured, the drug susceptibility testing was performed, and the data were statistically analyzed with the use of WHONET5.3 software recommended by the WHO. 5 RESULTS Of the pathogens cultured from the ascites that were obtained from the cases of infections, the gram-negative bacilli consisted of 46 （53.49%） strains of Ea＇cherichiacoli, 9 （10. 47%） strains of Klebsiella pneumoniae, 8 （9. 3%） strains of Pseudomonas aeruginosa, and 6 （6. 98%） strains of Mycobaeterium tuberculosis; the gram-positive cocci included 8 （9.3%） strains of Enterococcus faecalis, 8 （9.3%） strains of Staphylococcus epidermidis, and 1 （1.16%） strain of other species. The E. coli strains were highly resistant to ampicillin, cefalotin, and ciprofloxacin; the drug resistance rates to cefepime, cefoperazone, and amikacin were low. CONCLUSION The E. coli is the predominant species of pathogen causing the ascites infections in the liver cirrhosis patients complicated with spontaneous bacterial peritoantibiotics based on the result of drug susceptibility testing.

关 键 词：肝硬化 腹膜炎 细菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]