腹腔感染患者病原菌分布及耐药性和药敏分析  

Distribution,drug resistance and drug sensitivity of pathogens in patients with intra-abdominal infection

作　　者：潘剑飞 张泓[1] 戴成才[1] Pan Jianfei, Zhang Hong, Dai Chengcai(Dept of Emergency, The First Affiliated Hospital of Anhui Medical University, Hefei 23002)

机构地区：[1]安徽医科大学第一附属医院急诊医学科,合肥230022

出　　处：《安徽医科大学学报》2018年第3期453-457,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家临床重点专科建设项目(编号:卫办医政函[2012]649号)

摘　　要：目的明确腹腔感染患者病原菌分布及药敏试验结果,为临床合理选择抗感染方案提供理论依据。方法回顾性分析腹腔感染住院患者腹腔穿刺液或引流液的病原菌培养和药敏试验结果。结果 3 509例腹腔感染标本培养阳性405例。病原菌共计436株,其中革兰阴性菌268株(61.47%),革兰阳性菌151株(34.63%),真菌17株(3.90%)。居前5位的是大肠埃希菌(22.25%)、鲍曼不动杆菌(10.09%)、肺炎克雷伯菌(9.86%)、屎肠球菌(7.80%)、金黄色葡萄球菌(4.13%)。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶率分别为58.76%和16.28%。鲍曼不动杆菌中多重耐药菌占79.55%。屎肠球菌中检出对万古霉素耐药株(8.82%);耐甲氧西林的金黄色葡萄球菌(MRSA)在金葡菌中检出率为72.22%,耐甲氧西林凝固酶阴性的葡萄球菌(MRCNS)在凝固酶阴性的葡萄球菌中检出率为51.92%。结论腹腔感染病原菌以大肠埃希菌为主,其次分别为鲍曼不动杆菌、肺炎克雷伯菌、屎肠球菌和金黄色葡萄球菌;MRSA和MRCNS检出率较高;腹腔感染病原菌整体耐药形势严峻。Objective To investigate the distribution of pathogens and the results of drug sensitivity test in patients with intra-abdominal infection, and to provide theoretical basis for the rational selection of anti-infective programs. Methods The pathogenic bacteria culture and drug sensitivity test results of peritoneal fluid or drainage fluid in hospitalized patients with intra-abdominal infection were retrospectively analyzed. Results 405 cases of positive culture results were obtained in 3 509 cases of intra-abdominal infection specimens, A total of 436 strains of patho- gens, including 268 strains of Gram-negative bacteria （61.47%）, 151 strains of Gram-positive bacteria （34. 63% ）, 17 strains of Fungi （3.90%）. The top five were Escherichia coli （22. 25% ）, Acinetobacter bauman- nii （ 10. 09% ）, Klebsiella pneumordae （ 9.86% ） , Enterococcus faecium （ 7.80% ）, Staphylococcus aureus （4. 13% ）. The extended spectrum I8-1actamas rates of Escherichia coli and Klebsiella pneumoniae were 58. 76% and 16. 28%, respectively. The multi-drug resistant strains of Acinetobacter baumannii were 79.55%. Vancomycin resistant strains were detected in Enterococcusfaecium （8.82%）, the detection rate of methicillin-resistant Staphy- lococcus aureus （MRSA） in Staphylococcus aureus was 72. 22%, and the detection rate of methicillin-resistant Staphylococcus aureus （MRCNS） in coagulase-negative Staphylococci was 51.92%. Conclusion The main patho- gens of intra-abdominal infection is Escherichia coli, followed by Acinetobacter baumannii, Klebsiella pneumoniae, Enterococcus faecium and Staphylococcus aureus, the detection rate of MRSA and MRCNS is high. The overall drug resistance of intra-abdominal infection is serious.

关 键 词：腹腔感染 病原菌分布 耐药性 药敏 

分 类 号：R446.5[医药卫生—诊断学] R372[医药卫生—临床医学]