乳腺疾病患者病原菌分布及药敏分析  

Pathogen Distribution and Drug Susceptibility Analysis in Patients with Breast Diseases

作　　者：刘敏[1] 杨莉莉[1] 唐韵 杨菊艳 张峻梅[1] 冯小艳[1] 彭溪[1] Liu Min;Yang Lili;Tang Yun;Yang Juyan;Zhang Junmei;Feng Xiaoyan;Peng Xi(Department of Laboratory Medicine,The Third People′s Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院实验医学科临床检验部,成都610031

出　　处：《成都医学院学报》2022年第4期488-491,495,共5页Journal of Chengdu Medical College

摘　　要：目的分析不同类型乳腺疾病患者病原菌分布及对抗生素的耐药性情况,以指导临床合理使用抗菌药物。方法回顾性分析成都市第三人民医院2015年1月至2021年12月送检的579例不同类型乳腺疾病患者标本病原微生物分布情况和药敏实验结果。结果579份标本中细菌检出率为38.9%(225/579),其中乳腺炎患者细菌检出率最高为44.9%(150/334)。共分离出病原菌229株,其中革兰氏阳性菌191株(83.4%),革兰氏阴性菌33株(14.4%),真菌3株(1.3%),厌氧菌2株(0.9%)。主要病原菌为金黄色葡萄球菌,占41.9%(96/229);其次为棒状杆菌属和凝固酶阴性葡萄球菌,分别占21.8%(50/229)和13.5%(31/229)。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为30.2%(29/96);凝固酶阴性耐甲氧西林葡萄球菌(MRS)检出率为74.2%(23/31);葡萄球菌属对青霉素、红霉素、克林霉素耐药率较高,分别为85.8%(109/127),51.2%(65/127)、59.1%(75/127);未发现对万古霉素、达托霉素、辛内吉、利奈唑胺耐药的葡萄球菌菌株。凝固酶阴性葡萄球菌耐药性普遍高于金黄色葡萄球菌。结论不同乳腺疾病患者病原菌的检出率和分布有所差异,但主要以革兰氏阳性菌为主,金黄色葡萄球菌是乳腺疾病感染的主要病原菌,棒状杆菌和非结核分枝杆菌也是乳腺炎的重要致病菌,应提高其检出率。葡萄球菌属对青霉素、红霉素、克林霉素耐药率较高,建议临床使用抗菌药物前及时送检标本进行细菌培养,以药敏结果指导临床合理用药。Objective To explore the distribution characteristics and drug resistance of pathogens in patients with different types of breast diseases,so as to provide data basis for rational use of antibacterial drugs.Methods The pathogens and their drug susceptibility results of 579 specimens collected from patients with breast diseases treated in the Third People′s Hospital of Chengdu from January 2015 to December 2021 were retrospectively analyzed.Results Bacterial detection rate in 579 specimens from patients with different breast diseases was 38.9%(225/579),of which the highest was 44.9%(150/334)in patients with mastitis.A total of 229 pathogenic strains were isolated,including 191 strains of Gram-positive bacteria(83.4%),33 strains of Gram-negative bacteria(14.4%),3 strains of fungi(1.3%)and 2 strains of anaerobic bacteria(0.9%).The main pathogen was Staphylococcus aureus,accounting for 41.9%(96/229),followed by the corynebacterium genera and coagulase-negative Staphylococcus,accounting for 21.8%(50/229)and 13.5%(31/229),respectively.The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 30.2%(29/96),and that of coagulase-negative methicillin-resistant Staphylococcus(MRS)was 74.2%(23/31).The resistance rates of Staphylococcus to penicillin,erythromycin and clindamycin were 85.8%(109/127),51.2%(65/127)and 59.1%(75/127),respectively.No Staphylococcus strains resistant to vancomycin,daptomycin,synercid,and linezolid were found.The drug resistance of coagulase-negative Staphylococcus was generally higher than that of Staphylococcus aureus.Conclusion The detection rate and distribution of pathogens in different breast diseases vary,but mainly with Gram-positive bacteria.Staphylococcus aureus is the main pathogen of breast disease infection,followed by Corynebacterium bacteria and non-tuberculous Mycobacterium bacteria,and their detection rate should be improved.Staphylococcus has a high resistance rate to penicillin,erythromycin and clarithromycin.Specimens should be submitted for bacterial culture an

关 键 词：乳腺疾病 病原菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]