107例乳腺脓液的病原菌分布及耐药性分析  

Pathogens distribution and their drug resistance in 107 cases of mammary gland abscess

作　　者：王育瑛[1,2] 杨玮[2] 吕凌云[2] 夏大静[1] 

机构地区：[1]浙江大学医学院,浙江杭州310027 [2]杭州市中医院检验科,浙江杭州310007

出　　处：《中国微生态学杂志》2014年第12期1437-1440,共4页Chinese Journal of Microecology

摘　　要：目的了解乳腺疾病患者乳腺脓液的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2012年1月至2013年12月杭州市中医院乳腺外科门诊和住院送检的乳腺脓肿标本共107例。采用法国梅里埃公司的Vi TEK-2 compact全自动微生物鉴定仪进行菌种的鉴定和药物敏感性测定。结果107例标本中65例采集于哺乳期或非哺乳期急性乳腺炎患者,其中30例标本分离出病原菌,分离率为46.1%。分离出的30株病原菌中以金黄色葡萄球菌为主,共19株占63.3%,其他菌株共11株占36.7%。42例标本采集于乳腺增生性疾病术后患者,其中11例分离出病原菌,分离率为26.2%。主要病原菌为金黄色葡萄球菌,共7株占63.6%,其他菌株共4株占26.4%。药敏分析得出金黄色葡萄球菌青霉素的耐药率达90.3%,其次红霉素和克林霉素耐药率分别为64.5%、58.1%,检出耐甲氧西林金黄色葡萄球菌8株,检出率为30.8%。结论乳腺炎患者和乳腺增生性疾病术后患者感染的病原菌检出率有所差异,但菌株分布相似,主要病原菌均以革兰阳性球菌尤其是金黄色葡萄球菌为主。所分离金黄色葡萄球菌对青霉素的耐药率极高,对红霉素和克林霉素也有较高的耐药率。Objective To explore the pathogenic bacteria distribution and their drug resistance of mammary gland abscess in mastitis patients and guide the clinical use of antimicrobial agents. Methods 107 samples of mammary gland abscess from outpatients and inpatients of Hangzhou TCM hospital between Jan 2012 and Dec 2013 were col- lected. Species identification and drug susceptibility test were carried out using a ViTEK-2 compact full-automatic Microbe System manufactured by BioMerieux, France. Results Among the 107 samples, 65 were collected from breast-feeding or non-breast-feeding mastitis patients, in which pathogenic bacteria were isolated from 30 samples （30/65, 46. 1% ）. Staphylococcus aureus was the predominant species in these 30 samples and 19 of which were detected （19/30, 63.3% ）. The remaining 42 samples were collected from postoperative patients with proliferative breast diseases, in which pathogenic bacteria were isolated from 11 samples （11/42, 26. 2% ）. 7 Staphylococcus aureus isolates were detected from these 11 samples （7/11, 63.6% ）. Antimicrobial susceptibility test showed that 88.5% of staphylococcus aureus isolates produced β-1aetamase, and the resistance rate against penicillin reached 90. 3%. 8 isolates were detected as methicillin-resistant staphylococcus aureus （8/26, 30. 8% ）. The resistance rate of staphylococcus spp. isolates against erythromycin and clindamycin reached 64. 5% and 58. 1% , respectively. Conclusion The detection rates of the pathogenic bacteria are different in between mastitis patients and postoperative patients with proliferative breast diseases, but the species distribution is similar. The predominant patho- genic bacteria are gram positive cocci, mainly staphylococcus aureus, which is highly resistant against penicillin, e- rythromycin and clindamycin.

关 键 词：乳腺炎 金黄色葡萄球菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]