自发性腹膜炎患者腹水病原菌分布及耐药性分析  

作　　者：蔡莎莎[1] 喻长法[1] 闫李侠[1] 段达荣[1] 蒋亚萍[1] 

机构地区：[1]浙江省台州市第一人民医院,318020

出　　处：《浙江临床医学》2016年第11期2105-2107,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省台州市黄岩区科技局资助项目（201305926）

摘　　要：目的探讨自发性细菌性腹膜炎（SBP）患者腹水病原菌分布及耐药性，并提供用药参考。方法回顾性分析2012年1月至2015年11月137例SBP患者的临床资料、腹水培养和药物敏感试验结果。结果共分离出137株病原菌，其中革兰阴性菌62．0％，革兰阳性菌35．8％，真菌2．2％。共发现产EsBLs大肠埃希菌28株（60．9％），产ESBLs肺炎克雷伯菌6株（31．6％）。革兰阴性菌对亚胺培南、阿米卡星、哌拉西林／他唑巴坦和头孢哌酮／舒巴坦比较敏感，所有革兰阳性菌均对万古霉素敏感。结论革兰阴性菌是SBP患者最常见病原菌，并对抗生素高度耐药。因此应该合理使用抗生素，减少耐药菌株和产ESBLs菌株的产生。Objective Spontaneous bacterial peritonitis （ SBP ） had poor outcome, when bacterial resistance or even multidrug resistance occurred. To investigate bacterial profile and drug resistance in patients of SBP with ascites, and provide the reference for use of antibiotics. Method The clinical data, the results of ascites culture and drug sensitivity tests in patients of SBP from January 2012 to November 2015 were analyzed retrospectively. Results Among 137 strains of pathogens, the gram-negative bacteria accounted for up to 62.0% while the gram-positive bacteria were 35.8%, and the fungi were 2.2%. There were 28 （ 60.9% ） strains of ESBLs-producing Escherichia coli and 6 （ 31.6% ） strains of ESBLs-producing Klebsiella pneumonia. Gram-negative bacteria were highly sensitive to imipenem, amikaci, piperacillin/tazobactam, and cefoperazone/sulbactam. All the gram-positive bacteria were sensitive to vancomycin. Conclusion The gram-negative bacteria are the most common pathogens isolated from patients of SBP and are highly resistant to antibiotics. So antibiotics should be reasonably used to decrease the occurrence of drug resistant strains and ESBLs- producing strains.

关 键 词：自发性细菌性腹膜炎 耐药 抗生素 

分 类 号：R181.34[医药卫生—流行病学]