肝硬化失代偿期患者感染病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing infections in patients with decompensated liver cirrhosis

作　　者：吴刚[1] 陈文[1] 盛云建[1] 李烨[1] 

机构地区：[1]泸州医学院附属医院感染科,四川泸州646000

出　　处：《中华医院感染学杂志》2015年第13期2943-2945,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科研基金资助项目(12094)

摘　　要：目的：探讨慢性重型肝炎及肝硬化失代偿期医院感染病原菌分布及耐药性，为临床治疗提供参考。方法回顾性分析2012年1月－2014年1月医院收治的慢性重型肝炎及肝硬化失代偿期患者1056例临床资料，并采集患者的血液、痰液以及咽拭子标本进行细菌培养，药敏试验采用K‐B纸片扩散法进行检测。结果慢性重型肝炎患者感染40例，感染率为18．52％；失代偿期肝硬化患者感染76例，感染率为9．05％；培养出的病原菌主要有革兰阴性菌、革兰阳性菌及真菌，分别占60．38％、24．53％及15．09％；主要革兰阴性菌对亚胺培南、美罗培南及哌拉西林耐药率均为0，对头孢他啶的耐药率约30．00％，对头孢吡肟、阿莫西林、庆大霉素、氨曲南的耐药率为60．00％～80．00％；主要革兰阳性菌对万古霉素耐药率为0，对阿奇霉素、头孢唑林、苯唑西林、环丙沙星及庆大霉素的耐药率约10．00％，对哌拉西林、亚胺培南的耐药率为50．00％～60．00％。结论对慢性重型肝炎及失代偿期肝硬化患者发生感染的病原菌分布及耐药性进行分析，有利于临床治疗。OBJECTIVE To explore the distribution and drug resistance of pathogens causing nosocomial infections in patients with chronic severe hepatitis and decompensated liver cirrhosis so as to provide guidance for clinical treatment .METHODS A total of 1 056 patients with chronic severe hepatitis and decompensated liver cirrhosis who were treated in the hospital from Jan 2012 to Jan 2014 were enrolled in the study ,then the clinical data of the pa‐tients were retrospectively analyzed ,the blood ,sputum ,and throat swab specimens were collected for bacterial culture ,and the drug susceptibility testing was performed by using K‐B disk diffusion method .RESULTS The in‐fections occurred in 40 patients with chronic severe hepatitis ,with the infection rate of 18 .52% ;the infections oc‐curred in 76 patients with decompensated liver cirrhosis ,with the infection rate of 9 .05% .Of the isolated patho‐gens ,60 .38% were the gram‐negative bacteria ,24 .53% were the gram‐positive bacteria ,and 15 .09% were the fungi .The drug resistance rates of the main gram‐negative bacteria to imipenem ,meropenem ,and piperacillin were 0 ,the drug resistance rate to ceftazidime was about 30 .00% ,and the drug resistance rates to cefepime , amoxicillin ,gentamycin ,and aztreonam ranged from 60 .00% to 80 .00% .The drug resistance rate of the main gram‐positive bacteria to vancomycin was 0 ,the drug resistance rates to azithromycin ,cefazolin ,oxacillin ,cipro‐floxacin ,and gentamicin were about 10 .00% ,and the drug resistance rates to piperacillin and imipenem ranged from 50 .00% to 60 .00% .CONCLUSION The understanding of the distribution and drug resistance of the patho‐gens causing infections is conducive to the clinical treatment of the patients with chronic severe hepatitis and de‐compensated liver cirrhosis .

关 键 词：医院感染 病原菌 耐药性 慢性重型肝炎 失代偿期肝硬化 

分 类 号：R378[医药卫生—病原生物学]