儿童穿孔性阑尾炎的病原学分析及抗生素选用  

The Etiological Analysis and Their Relation to the Antibiotic Treatment in Children with Perforated Appendicitis

作　　者：李涛[1] 李巍松[1] 王慧珍 刘虎[1] LI Tao;LI Weisong;WANG Huizhen;LIU Hu(Department of Pediatric Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of General Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院小儿外科,合肥230022 [2]安徽医科大学第一附属医院普外科,合肥230022

出　　处：《宁夏医科大学学报》2022年第2期203-206,共4页Journal of Ningxia Medical University

基　　金：安徽省自然科学基金青年项目(2008085QH408)。

摘　　要：目的分析穿孔性阑尾炎患儿的腹腔脓液细菌培养及药敏结果。方法收集2017年12月至2020年11月收治的125例穿孔性阑尾炎患儿的腹腔脓液细菌培养和药敏试验结果,总结儿童穿孔性阑尾炎病原菌构成及病原菌对常用抗生素的敏感率。结果125例穿孔性阑尾炎患儿,有49例因术后治疗效果不佳调整抗生素;发病前使用过头孢类抗生素者66例,调整抗生素组患者的头孢类抗生素使用率(36.0%)高于未调整抗生素组(16.8%)(χ^(2)=49.280,P<0.001);腹腔脓液标本中培养出病原菌者119例,大肠埃希菌、铜绿假单胞菌及肺炎克雷伯菌对头孢曲松、氨苄西林/舒巴坦敏感率较低,对头孢吡肟、亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的敏感率较高。结论儿童穿孔性阑尾炎的病原菌构成中大肠埃希菌比例最高,对临床常用的头孢曲松敏感率低,腹腔脓液细菌培养和药敏试验对术后抗生素应用有指导意义。Objective To analyze the results of celiac pus bacteria culture and drug sensitivity test in children with perforated appendicitis in our hospital,so to supply the guidance for the application of antibiotics in clinic.Methods For 125 cases of perforated appendicitis in children from December 2017 to November 2020,the reports of celiac pus bacteria culture and drug sensitivity test were collected to sum up the data including common pathogens and sensitivity of common pediatric drugs.Results Among 125 children with perforated appendicitis,49 cases were adjusted for antibiotics due to poor postoperative treatment.There were 66 cases who used cephalosporins before the onset of the disease,and the use rate of cephalosporins in the adjusted antibiotic group(36.0%)was higher than that in the unadjusted antibiotic group(16.8%)(χ^(2)=49.280,P<0.001)A total of 119 cases of pathogens were isolated from the peritoneal pus.Among them,Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae were less sensitive to ceftriaxone and ampicillin/sulbactam,but more sensitive to cefepime,imipenem,meropenem,Cefoperazone/sulbactam and piperacillin/tazobactam.Conclusion Escherichia coli had the highest proportion in the pathogen composition of perforated appendicitis in children,and its sensitivity to ceftriaxone was low.Bacterial culture and drug sensitivity test of peritoneal pus had guided significance for postoperative antibiotic application.

关 键 词：儿童 穿孔性阑尾炎 细菌培养 药敏试验 

分 类 号：R574.61[医药卫生—消化系统]