急性阑尾炎病原菌分布与耐药性分析  

The distribution and drug resistance of pathogens causing acute appendicitis

作　　者：钟金妹[1] 黄小明[1] 顾涛[2] 李海[3] 

机构地区：[1]昆山市第一人民医院急诊医学科,江苏昆山215300 [2]昆山市第一人民医院临床检验科-微生物室,江苏昆山215300 [3]昆山市第一人民医院病理科,江苏昆山215300

出　　处：《中华医院感染学杂志》2015年第16期3695-3696,3708,共3页Chinese Journal of Nosocomiology

基　　金：江苏省科技支撑计划基金资助项目(BE2009611)

摘　　要：目的探讨急性阑尾炎患者脓液病原菌培养结果及耐药性,为临床治疗提供参考依据。方法选取2011年1月-2013年12月医院收治的624例急性阑尾炎患者作为研究对象,在行阑尾切除术中采集患者的脓液标本,对624份脓液标本进行病原菌培养和耐药性分析,数据采用WHONET 5.4进行统计分析。结果 624例急性阑尾炎脓液标本中有408份标本培养检出438株病原菌,以革兰阴性菌为主,共428株占97.7%,占前4位为大肠埃希菌、铜绿假单胞菌、克雷伯菌属、产气肠杆菌,分别占72.6%、10.5%、5.7%、2.5%;大肠埃希菌对替卡西林、氨苄西林、环丙沙星、头孢噻吩、庆大霉素有较高耐药;铜绿假单胞菌对氨苄西林、头孢噻吩、替卡西林、头孢他啶均有较高耐药性;克雷伯菌属对替卡西林、氨苄西林、头孢噻吩耐药率较高,均>50.0%。结论急性阑尾炎患者的感染主要以革兰阴性菌为主,且大肠埃希菌最为常见,不同病原菌对不同的抗菌药物耐药性有差异,临床上应选择合理抗菌药物治疗。OBJECTIVE To investigate the germicultures results and drug resistance of fester pathogens in patients with acute appendicitis ,so as to provide a reference for clinical treatment .METHODS From Jan .2011 to Dec . 2013 ,624 cases of acute appendicitis patients in our hospital were selected as study objects .The fester samples were collected during appendectomy .Pathogenic culture and drug resistance analysis were conducted to the 624 samples and all data were analyzed by WHONET 5 .4 .RESULTS Totally 408 samples were cultured to detect 438 strains of pathogens ,dominating by gram‐negative bacteria with 428 strains ,accounting for 97 .7% .The top four bacteria detected were E .coli（72 .6% ） , Pseudomonas aeruginosa （10 .5% ） , K lebsiella pneumoniae （5 .7% ） , and Enterobacter aerogenes （2 .5% ）;and the E .coli had high drug resistance to ticarcillin （94 .7% ） ,ampicillin （83 .0% ） ,ciprofloxacin （82 .7% ） ,cephalothin （82 .1% ） ,and gentamicin （74 .8% ）;P .aeruginosa were serious‐ly resistant to ampicillin （100 .0% ） ,cefalotin （100 .0% ） ,ticarcillin（86 .5% ） ,and ceftazidime（64 .3% ）;Kleb‐siella were highly resistant to ticarcillin （98 .3% ） , ampicillin （96 .3% ） , and cephalothin （73 .6% ） . CONCLUSION Infections in patients with acute appendicitis are mainly caused by gram‐negative bacteria ,common‐ly E .coli .Different pathogens showed differences in drug resistance to various antibiotics Rational antibiotic ther‐apy should be carefully selected clinically .

关 键 词：急性阑尾炎 脓液 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]