肛周脓肿患者脓液细菌培养及药物敏感性分析  

Bacterial Culture and Drug Sensitivity Analysis of Pus Specimen in Patients with Perianal Abscess

作　　者：王建设[1] 马志才[1] WANG Jian-she;MA Zhi-cai(Taizhou Fourth People's Hospital,Taizhou,Jiangsu 225300)

机构地区：[1]江苏省泰州市第四人民医院,江苏泰州225300

出　　处：《中国肛肠病杂志》2024年第2期29-32,共4页Chinese Journal of Coloproctology

摘　　要：目的:了解肛周脓肿患者病原菌分布特点及药物敏感性,为临床选择有效抗生素提供参考依据。方法:以2020年1月至2022年6月于泰州市第四人民医院行肛周脓肿切开引流术的120例患者为研究对象,术中采集脓液标本120份进行细菌培养和药敏试验,分析病原菌的分布情况及其耐药性。结果:120份肛周脓肿脓液标本中,8份(6.67%)标本未培养出细菌,112份(93.33%)标本培养出细菌(8种),其中革兰阴性菌91株(81.25%),革兰阳性菌21株(18.75%);排在前3位的病原菌为大肠埃希菌(57株,50.89%)、肺炎克雷伯菌(29株,25.89%)和金黄色葡萄球菌(13株,11.61%)。91株革兰阴性菌对哌拉西林钠/他唑巴坦钠、头孢哌酮钠舒巴坦钠、亚胺培南、美罗培南、替加环素、头孢替坦、多利培南、厄他培南的耐药率为0;对替卡西林、哌拉西林、四环素、萘啶酸、氨苄西林的耐药率超过50%。革兰阳性菌对氨苄西林、阿莫西林/克拉维酸钾、红霉素、庆大霉素、苯唑西林、青霉素、甲氧苄氨嘧啶的耐药率超过60%;对达托霉素、利奈唑胺、万古霉素、替考拉宁、替加环素、亚胺培南的耐药率低于5%。检出多重耐药菌39株(34.82%)。结论:肛周脓肿的病原菌以革兰阴性杆菌为主,其中主要是大肠埃希菌,多重耐药菌检出率较高。临床上应根据药敏试验结果选用和调整敏感抗生素。Objective To study the distribution characteristics and drug sensitivity of pathogenic bacteria in patients with perianal abscess,and to provide reference for the clinical selection of effective antibiotics.Methods Total 120patients with perianal abscess who underwent incision and drainage in Taizhou Fourth People's Hospital from January 2020to June 2022were selected as the study objects.Total 120pus specimens were collected during the operation for bacterial culture and drug sensitivity test,and the distribution and drug resistance of pathogenic bacteria were analyzed.Results For 120pus specimens of perianal abscess,no bacteria were cultured in 8specimens(6.67%),and 8kinds of bacteria were cultured in 112specimens(93.33%),including 91strains of Gram-negative bacteria(81.25%)and 21strains of Gram-positive bacteria(18.75%).The top 3pathogens were Escherichia coli(57strains,50.89%),Klebsiella pneumoniae(29strains,25.89%)and staphylococcus aureus(13strains,11.61%).The resistance rate of 91strains of gram-negative bacteria to Piperacillin Sodium/Tazobactam Sodium,Cefoperazone Sodium,Sulbactam Sodium,Imipenem,Meropenem,Tigecycline,Cefotetan,Doripenem and Ertapenem was 0.The resistance rate to Ticacillin,Piperacillin,Tetracycline,Nalidixic Acid and Ampicillin exceeded 50%.The resistance rate of Gram-positive bacteria to Ampicillin,Amoxicillin/Clavulanate Potassium,Erythromycin,Gentamicin,Oxacillin,Penicillin,Trimethoprim was more than 60%.The drug resistance rates of Daptomycin,Linezolid,Vancomycin,Teicoplanin,Tigecycline and Imipenem were less than 5%.Thirtynine strains(34.82%)of multiple resistant bacteria were detected.Conclusion The main pathogens of perianal abscess are Gram-negative bacteria,mainly Escherichia coli,and the detection rate of multiple resistant bacteria is high.Clinically,sensitive antibiotics should be selected and adjusted according to the results of drug sensitivity test.

关 键 词：肛周脓肿 脓液 微生物培养 病原菌 药敏试验 

分 类 号：R446.5[医药卫生—诊断学] R657.15[医药卫生—临床医学]