218例肛周脓肿患者脓液培养及药物敏感情况分析  

Analysis of Pus Culture and Drug Sensitivity in 218 Patients with Peri-Anal Abscess

作　　者：赵高斯 张小元 高钰莹 商俊芳[2] ZHAO Gao-si;ZHANG Xiao-yuan;GAO Yu-ying;SHANG Jun-fang(Affil.Hosp.of Gansu Uni.of Chinese Med.,Lanzhou 730020;2nd Hosp.,Lanzhou Uni.,Lanzhou 730030)

机构地区：[1]甘肃中医药大学附属医院,甘肃兰州730020 [2]兰州大学第二医院,甘肃兰州730030

出　　处：《微生物学杂志》2020年第6期91-95,共5页Journal of Microbiology

基　　金：甘肃中医药大学附属医院院内项目(GZFY-2017-08);第六批全国老中医药专家学术继承项目(国中医药人教发2017-29号);甘肃省科技支撑计划项目(1304FKCA109);甘肃省中医药科研课题项目(GZK-2019-31)。

摘　　要：通过回顾性归纳分析218例原发性成脓期肛周脓肿患者脓液标本细菌培养及药敏试验结果,了解肛周脓肿患者脓液中主要致病菌分布情况及药敏试验状况。结果表明,218例患者脓液培养共分离出病原菌247株,革兰阳性菌41株(占16.6%),革兰阴性菌206株(占83.40%),差异具有统计学意义(P<0.05)。革兰阴性菌中大肠埃希菌(Escherichia coli)145株(占58.71%),肺炎克雷伯菌(Klebsiella pneumoniae)38株(占15.38%),差异具有统计学意义(P<0.05)。药敏试验显示革兰阴性菌对亚胺培南、丁胺卡那、美罗培南、哌拉西林/他唑巴坦敏感率为100%,对替卡西林/克拉维酸、头孢哌酮/舒巴坦、米诺环素、氯霉素、头孢西丁、头孢吡肟、头孢他啶敏感率均达到85%以上;革兰阳性菌对万古霉素、亚胺培南、利奈唑胺敏感率为100%,对替考拉宁、链霉素、氯霉素、左氧氟沙星、头孢吡肟敏感率均达到85%以上,均为敏感抗菌药物。肛周脓肿患者致病菌分布发生了改变,革兰阴性菌占比下降,革兰阳性菌占比上升,仍以大肠埃希菌急性感染为主。临床上存在敏感抗菌药物,可以首选头霉素类抗生素头孢西丁治疗肛周脓肿,然后根据具体药敏试验结果及时调整使用敏感的抗生素。In order to understand the distribution of main pathogenic bacteria in the pus of patients with peri-anal abscess and the results of drug sensitivity test,a retrospective analysis of bacterial culture and drug sensitivity test results of 218 patients with essential peri-anal abscess was used as a method.The results showed that a total of 247 strains of pathogenic bacteria were isolated from 218 patients′pus culture,41 strains of Gram-positive bacteria accounted for 16.60%,206 strains of Gram-negative bacteria accounted for 80.78%,the difference was statistically significant(P<0.05).There were 145 strains of E.coli(58.71%)and 38 strains of Klebsiella pneumoniae(15.38%)in Gram-negative bacteria,the difference was statistically significant(P<0.05).The sensitivity of Gram-negative bacteria to imipenem,amikacin,meropenem,piperacillin/tazobactam was 100%,to ticarcillin/clavulanic acid,cefoperazone/sulbactam,minocycline,chloramphenicol,cefoxitin,cefepime and ceftazidime was more than 85%.The sensitivity of Gram-positive bacteria to vancomycin,imipenem and linezolid was over 85%.The sensitivity rate to teicoplanin,streptomycin,chloramphenicol,levofloxacin and cefepime was over 85%,all of them were sensitive antibiotics.Therefore,the distribution of pathogenic bacteria in patients with peri-anal abscess has changed,the proportion of Gram-negative bacteria has decreased,the proportion of Gram-positive bacteria has increased,but the main cause is still acute infection of E.coli.There are sensitive antibiotics in clinic.Cephalosporin can be used as the first choice in the treatment of peri-anal abscess,and then sensitive antibiotics can be adjusted in time according to the specific drug sensitivity test results.

关 键 词：肛周脓肿 细菌培养 药敏试验 致病菌 脓液 

分 类 号：Q939.93[生物学—微生物学]