肝硬化患者气单胞菌肠道外感染的临床特征及耐药性分析  

The clinical characteristics and drug resistance of extra-intestinal infection of aeromonas in patients with hepatic cirrhosis

作　　者：丁秀荣[1] 于艳华[1] 陈铭[1] 王晨[1] 康艳芳[1] 娄金丽[1] Ding Xiurong;Yu Yanhua;Chen Ming;Wang Chen;Kang Yanfang;Lou Jinli(Departments of Clinical Laboratory,Beijing You＇an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院临床检验中心,100069

出　　处：《北京医学》2018年第10期912-915,共4页Beijing Medical Journal

摘　　要：目的分析肝硬化患者气单胞菌肠道外感染的临床及病原学特点,为临床治疗提供依据。方法回顾性分析首都医科大学附属北京佑安医院61例肝硬化合并肠道外气单胞菌感染者的临床资料和微生物学特点。结果培养出气单胞菌61株,其中嗜水气单胞菌20株,豚鼠气单胞菌20株,温和气单胞菌18株,维隆气单胞菌3株。其中社区感染35例(57.4%),以嗜水气单胞菌最多(18例);院内感染26例(42.6%),以豚鼠气单胞菌最多(16例)。主要临床表现为发热、腹痛、腹胀、肝性脑病等。该菌属对阿米卡星(95.1%)、头孢吡肟(93.4%)和亚胺培南(93.4%)的敏感率高。而豚鼠气单胞菌对第3代头孢菌素的敏感性显著低于其他菌种。结论肝硬化患者气单胞菌感染的临床表现缺乏特异性,不同菌种对抗生素耐药性差异较大,及早培养并根据药敏结果选择抗生素对治疗至关重要。Objective To analyze the clinical and pathogenic characteristics in Aeromonas extra-intestinal infection of patients with hepatic cirrhosis, in order to provide basis for clinical therapy. Methods The clinical information, microbial sensitivity and outcome in 61 cases of Aeromonas extra-intestinal infection of patients with hepatic cirrhosis from June 2012 to June 2017 were analyzed retrospectively. Results Among 61 cases of Aeromonas extra-intestinal infection,35 cases（57.4%） were community-acquired infection and 26 cases（42.6%） were nosocomial infection. Total 61 Aeromonas clinical isolates were seperated from those patients, among which 20 Aeromonas hydrophila isolate, 20 Aeromonas caviae isolates, 18 Aeromonas sobria isolates, and 3 Aeromonas veronii isolates were included. The main clinical manifestations were fever, followed by abdominal distension and pain, hepatic encephalopathy, and so on. Most Aeromonas isolates were susceptible to amikacin, cefepime and imipenem. In comparison, the susceptibility of the Aeromonas caviae isolates to ceftazidime, cefotaxime and pipercilinazole was significantly lower than those of other species. Conclusion The clinical manifestations of Aeromonas infection in patients with cirrhosis are lack of specificity. There is great difference in resistances among different Aeromonas isolates. Rational use of antibiotics based on the results of bacteria culture and drug sensitivity is important to treatment of aeromonas infection.

关 键 词：气单胞菌属 肝硬化 肠道外感染 临床特征 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R575.2[医药卫生—临床医学]