糖尿病患者细菌性肝脓肿的临床特征与病原菌分布  

Clinical features and pathogen distribution of diabetic patients with bacterial liver abscess

作　　者：许建新[1,2] 纪明锁 任敬[2] 郭欣[2] 王洪玉[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市泰达医院呼吸感染科,天津300457

出　　处：《中华医院感染学杂志》2016年第7期1546-1547,1565,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81101250)

摘　　要：目的研究糖尿病患者细菌性肝脓肿的临床特征与病原菌分布,为其诊断、治疗及预后判断提供依据。方法选择2013年11月-2015年3月在医院收治的糖尿病发生细菌性肝脓肿患者80例,对80例患者行肝脏穿刺脓液培养,观察并记录患者病原学组成及培养结果,分析检出病原菌的分布及其耐药性,数据采用SPSS16.0软件进行统计分析。结果 80例糖尿病细菌性肝脓肿患者的临床特征主要包括发热、腹痛、贫血等临床症状,分别占92.5%、25.0%、53.8%,肝脏脓灶大小(9.8±2.8)cm;检测出病原菌80株,革兰阴性菌63株占78.8%,革兰阳性菌17株占21.3%,其中检出肺炎克雷伯菌最多占60.0%;肺炎克雷伯菌和大肠埃希菌对阿米卡星、亚胺培南较敏感;金黄色葡萄球菌对青霉素耐药率较高为100.0%,对万古霉素敏感耐药率为0。结论糖尿病细菌性肝脓肿患者的临床特征以发热、腹痛、贫血为主,应根据病原菌的分布和耐药性合理选择抗菌药物,并及时根据药敏结果调整抗菌药物治疗方案,提高临床疗效。OBJECTIVE To study the clinical features and pathogen distribution of diabetic patients with bacterial liver abscess so as to provide the basis for the diagnosis,treatment and prognosis.METHODS Totally 80 cases of diabetic patients with bacterial liver abscess were selected from Nov.2011 to Mar.2015 in our hospital and they received liver puncture to cultivate the fester.The etiology and culture results were observed and recorded to analyze the distribution of pathogens and their drug resistance.SPSS 16.0 was adopted for statistical analysis.RESULTS The patient′s clinical symptoms mainly included fever,abdominal pain,and anemia,accounting for92.5%,25.0%and 53.8%.The lesion of liver fester was（9.8±2.8）cm.Gram-negative bacteria with 63 strains occupied 78.8% and gram-positive bacteria with 17 strains held 21.3%.Among them,Klebsiella pneumonia accounted for 60.0%.The results found that K.pneumoni and Escherichia coli were sensitive to amikacin and Imipenem.Staphylococcus aureus proved to be 100.0% resistant to penicillin while totally sensitive to vancomycin.CONCLUSIONThe clinical features of diabetic patients with bacterial liver abscess mainly manifest as fever,abdominal pain and anemia.Antibiotics should be chosen according to pathogen distribution and drug resistance and adjust the treatment timely according to drug sensitivity results so as to improve curative effect.

关 键 词：糖尿病 细菌性肝脓肿 临床特征 病原菌 分布 

分 类 号：R587.1[医药卫生—内分泌]