280例急性阑尾炎手术病人腹腔脓液细菌培养与药敏结果分析  

Analysis of the composition of pathogenic bacteria in abdominal pus and drug sensitivity test results in 280 patients with acute appendicitis

作　　者：卢卓才 王晓龙 汤婷婷 LU Zhuocai;WANG Xiaolong;TANG Tingting(Department of Gastrointestinal Surgery,Huadu District People's Hospital,Guangzhou 510800,China)

机构地区：[1]南方医科大学附属花都医院胃肠外科,广州510800

出　　处：《临床外科杂志》2022年第12期1152-1154,共3页Journal of Clinical Surgery

基　　金：广州市花都区人民医院院内重点学科(2022-2025年)项目。

摘　　要：目的分析急性阑尾炎手术病人腹腔脓液致病菌构成和药敏结果。方法2020年1月1日~2021年1月1日收治的急性阑尾炎病人280例,均行腹腔镜阑尾切除术,术中取病人腹腔积液,行细菌培养及药敏试验。细菌鉴定采用VTEK-MS质谱仪鉴定;药敏试验采用VITEK2-Compact全自动微生物分析仪或纸片扩散法。结果在致病菌构成方面,大肠埃希菌为最主要致病菌,占59.7%,其余为铜绿假单胞菌(11.2%)、肺炎克雷伯杆菌(6.6%);在药敏实验中,对大肠埃希菌敏感性最高的5种抗生素分别为:碳青霉烯类(100%)、阿米卡星(98.3%)、哌拉西林/他唑巴坦(97.4%)、头孢西丁(95.7%)、阿莫西林/克拉维酸钾(85.5%)。结论哌拉西林/他唑巴坦、头孢西丁、阿莫西林/克拉维酸钾、阿米卡星、碳青霉烯类抗生素对急性阑尾炎病人大肠埃希菌的敏感率均为70%以上,可根据临床情况酌情优先选用。Objective To count and analyze the composition of pathogenic bacteria inabdominal pus and drug sensitivity test results of patients with acute appendicitis.Methods From January 1,2020 to January 1,2021,280 patients with acute appendicitis received laparoscopic appendectomy.Intraoperatively,abdominal fluid was taken from the patients,and bacterial culture and drug sensitivity tests were performed.Bacteria were identified by VTEK-MS mass spectrometer;drug susceptibility tests were performed by VITEK2-Compact automatic microbiological analyzer or disk diffusion.Result In terms of the composition of pathogenic bacteria,Escherichia coli was the main pathogenic bacteria,accounting for 59.7%,followed by pseudomonas aeruginosa(11.2%)and klebsiella pneumoniae(6.6%).In drug susceptibility test,the five antibiotics with the highest sensitivity to Escherichia coli were:carbapenems(100%),amikacin(98.3%),piperacillin/tazobactam(97.4%),cefoxitin(95.7%),amoxicillin/clavulanate potassium(85.5%).Conclusion The sensitivity rates of piperacillin/tazobactam,cefoxitin,amoxicillin/clavulanate potassium,amikacin and carbapenems to Escherichia coli in patients with acute appendicitis are all above 70%,which can be preferred according to clinical situation.

关 键 词：急性阑尾炎 腹腔脓液 细菌培养 药物敏感试验 

分 类 号：R656.8[医药卫生—外科学] R446.5[医药卫生—临床医学]