临床胸腔感染病原菌分布及耐药性分析  

Analysis of distribution and drug resistance of pathogens in clinical pleural infection

作　　者：王立新[1] 王学民[1] 杨雅琼[1] 王毅[1] WANG Li-xin;WANG Xue-min;YANG Ya-qiong;WANG Yi(Department of Clinical Laboratory,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院检验科,天津300211

出　　处：《中国城乡企业卫生》2021年第10期8-11,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的分析临床上引起胸腔感染的病原菌分布及耐药性特点。方法回顾性分析2016年1月-2021年2月天津市天津医院住院患者胸腔积液标本分离的病原菌,采用VITEK-2 compacts全自动细菌分析仪及配套鉴定卡进行菌株鉴定,采用仪器法及纸片扩散法对菌种进行药敏试验。结果共分离出病原菌66株,其中革兰阳性球菌43株、占65.2%,革兰阴性杆菌14株、占21.2%,革兰阳性杆菌4株、占6.1%,厌氧菌3株、占4.5%,真菌2株、占3.0%。革兰阳性球菌对替加环素、万古霉素、利奈唑胺敏感率为100.0%,对青霉素和红霉素耐药率较高。凝固酶阴性葡萄球菌25株,其中耐甲氧西林株(MRCNS)19株、占76.0%,甲氧西林敏感株(MSCNS)6株、占24.0%。金黄色葡萄球菌8株,其中MRSA为1株、占12.5%,MSSA 7株、占87.5%。主要革兰阴性杆菌为鲍曼不动杆菌、占9.1%,表现为多重耐药菌。结论本研究中胸腔感染主要病原菌以凝固酶阴性葡萄球菌、金黄色葡萄球菌、鲍曼不动杆菌为主,在临床治疗过程中应结合药敏试验结果合理选择抗菌药物。Objective To investigate the distribution and drug resistance of pathogens in clinical pleural infection. Methods The pathogens isolated from pleural effusion specimens of inpatients in Tianjin Hospital from January 2016 to February 2021 were retrospectively analyzed. The strain identification were conducted by VITEK-2 compacts Auto Microbe System and matching identification card,antimicrobial susceptibility testing was carried out by instrumental method and Kirby-Bauer method. Results A total of 66 pathogenic strains were collected,with Gram-positive cocci 43 strains,accounting for 65.2%,Gram-negative bacilli 14 strains,accounting for 21.2%,Gram-positive bacilli 4 strains,accounting for 6.1%,Anaerobic bacteria3 strains,accounting for 4.5% and fungal 2 strains,accounting for 3.0%. The sensitivity rates of Gram-positive cocci to tigecycline,vancomycin and linezolid were 100.0%,and the resistance rate to penicillin and erythromycin were the higher. Coagulase-negative Staphylococcus was 25 strains,including methicillin resistant strain(MRCNS)19 strains,accounting for 76.0% and methicillin sensitive strain(MSCNS)6 strains,accounting for 24.0%. Staphylococcus aureus was 8 strains,including MRSA 1 strains,accounting for 12.5% and MSSA 7 strains,accounting for 87.5%. The main Gram-negative bacilli were Acinetobacter baumannii,accounting for 9.1%,which showed multidrug resistance. Conclusion Coagulase-negative Staphylococcus,Staphylococcus aureus and Acinetobacter baumannii were the main causes of pleural infection in this study. In the course of clinical treatment,antibiotics should be selected rationally in combination with the results of drug sensitivity test.

关 键 词：胸腔感染 胸水 病原菌 耐药性 

分 类 号：R372[医药卫生—病原生物学]