瘘管性肛周脓肿细菌培养及药敏分析  

Pathogen Distribution and Drug Sensitivity Analysis in Perianal Abscess Patients with Fistula

作　　者：张学诚[1] 张力方 王书君[3] ZHANG Xuecheng ZHANG Lifang WANG Shujun(Anus-intestins Department, The Affiliated Hospital of Chengde Medical College, Chengde 067000, China Department of Gynecology, Chengde Maternal and Child Health Care Hospital, Chengde 067000, China Department of Orthopaedics and Traumatology, The Affiliated Hospital of Chengde Medical College, Chengde 067000, China)

机构地区：[1]承德医学院附属医院肛肠科,河北承德067000 [2]承德市妇幼保健院妇科,河北承德067000 [3]承德医学院附属医院骨伤科,河北承德067000

出　　处：《中国医科大学学报》2016年第10期923-925,共3页Journal of China Medical University

基　　金：承德市科技支撑计划项目(201422032)

摘　　要：目的了解瘘管性肛周脓肿主要致病菌分布情况以及药物敏感情况,以指导临床合理使用抗生素。方法回顾性分析瘘管性肛周脓肿患者300例,采集肛周脓液,进行细菌培养鉴定,并对培养菌进行药敏试验。结果 300例患者中277例细菌培养阳性,阳性率为92.3%,共培养分离出369株病原菌,革兰阳性菌42株(占11.4%),革兰阴性菌327株(占88.6%),其中大肠埃希菌204株(占55.3%),其次为肺炎克雷伯菌67株(占18.2%)。革兰阳性菌对利奈唑烷和万古霉素敏感性最好;革兰阴性菌对亚胺培南和哌拉西林敏感性较好,敏感性均在95%以上。结论瘘管性肛周脓肿以肠源性细菌感染为主要来源,革兰阳性菌应首选利奈唑烷和万古霉素进行治疗,革兰阴性菌应首选亚胺培南和哌拉西林进行治疗。Objective To explore the main pathogenic bacteria distribution and drug sensitive situation in perianal abscess patients with fistula, so as to guide the rational use of antibiotics. Methods A total of 300 perianal abscess patients with fistula were retrospectively analyzed. Crissum pus was adopted for pus bacterial cuhure, identification and drug sensitive test. Results Among 300 patients, 277 were positive for germicultured with the positive rate of 92.3%. A total of 369 isolated strains of pathogenic bacteria were successful obtained, including 42 （11.4% ） strains of gram- positive bacteria and 327 （ 88.6% ） strains of gram-negative bacteria, of which 204 （ 55.3% ） strains were Escherichia coli, followed by 67 （ 18.2% ） strains of Klebsiella pneumoniae. The best two antibiotics of gram-positive bacterium were linezohd and vancomycin. The best two antibiotics of gram-negative bacterium were imipenem and piperacillin. All of them had a sensitivity above 95%. Conclusion Enterogenous infection was the main source of perianal abscess with fistula. The linezolid and vancomycin should be preferred for gram-positive bacteria txeatment, and imipenem and piperacillin should be preferred for bacterium of gram-negative treatment.

关 键 词：瘘管性肛周脓肿 细菌培养 耐药性 

分 类 号：R657.1[医药卫生—外科学]