颈部脓肿合并低蛋白血症患者的病原菌分布及药敏分析  

Distribution of pathogens and antibiotic sensitivity analysis in patients with neck abscesses complicated by hypoproteinemia

作　　者：景星滔 孔维丽[1] 陈漫琳 杨慧[1] JING Xingtao;KONG Weili;CHEN Manlin;YANG Hui(Department of Otolaryngology-Head and Neck Surgery,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,四川成都610041

出　　处：《西部医学》2025年第3期457-462,共6页Medical Journal of West China

基　　金：国家自然科学基金资助项目(82401341)。

摘　　要：目的探讨颈部脓肿合并或不合并低蛋白血症患者的临床特征、病原菌分布及药物敏感性,为临床治疗提供参考。方法回顾性分析2010年1月—2023年1月在本院行颈部脓肿切开引流手术的934例患者的临床资料。根据血清白蛋白水平将患者分为颈部脓肿合并低蛋白血症组(NAH组,n=207)和颈部脓肿无低蛋白血症组(NANH组,n=727)。比较两组患者的临床特征、病原菌分布及药物敏感性。结果两组在年龄、吸烟史、饮酒史、住院时间、高血压、糖尿病、喉阻塞、肝肾功能异常等方面比较,差异有统计学意义(均P<0.05)。颈部脓肿感染天数与血清白蛋白水平呈明显负相关。NAH组主要病原菌为肺炎克雷伯菌,NANH组主要为金黄色葡萄球菌。药敏结果显示,NAH组对妥布霉素、亚胺培南和左氧氟沙星敏感性最高,NANH组对利奈唑胺、万古霉素、奎奴普丁/达福普汀、替加环素、呋喃妥因、米诺环素和强力霉素敏感性最高。结论颈部脓肿合并低蛋白血症患者具有特殊的临床特征,需要个体化治疗策略。在缺乏药敏结果时,NAH组建议使用妥布霉素、亚胺培南和左氧氟沙星,NANH组可考虑使用利奈唑胺、万古霉素、奎奴普丁/达福普汀、替加环素、呋喃妥因、米诺环素和强力霉素。Objective To analyze clinical characteristics,pathogen distribution,and drug sensitivity in neck abscess patients with or without hypoalbuminemia,providing reference for clinical treatment.Methods Clinical data of 934 patients who underwent neck abscess incision and drainage surgery in our hospital from January 2010 to January 2023 were retrospectively analyzed.Patients were divided into neck abscess with hypoalbuminemia group(NAH group)and neck abscess without hypoalbuminemia group(NANH group)based on serum albumin levels.Clinical characteristics,pathogen distribution,and drug sensitivity were compared between the two groups.Results There were 207 cases in NAH group and 727 cases in NANH group.Significant differences were observed between the two groups in age,smoking history,alcohol consumption history,length of hospital stay,hypertension,diabetes,laryngeal obstruction,and liver and kidney dysfunction(all P<0.05).The infection days of neck abscess were negatively correlated with serum albumin level.The main pathogen in the NAH group was Klebsiella pneumoniae,while in the NANH group it was Staphylococcus aureus.Drug sensitivity results showed that in the NAH group,sensitivity was highest to tobramycin,imipenem,and levofloxacin,while in the NANH group,sensitivity was highest to linezolid,vancomycin,quinupristin/dalfopristin,tigecycline,nitrofurantoin,minocycline,and vibramycin.Conclusion Neck abscess patients with hypoalbuminemia have specific clinical characteristics and require individualized treatment strategies.In the absence of drug sensitivity results,tobramycin,imipenem,and levofloxacin are recommended for the NAH group,while linezolid,vancomycin,quinupristin/dalfopristin,tigecycline,nitrofurantoin,minocycline,and vibramycin can be considered for the NANH group.

关 键 词：颈部脓肿 低蛋白血症 病原菌 药物敏感性 治疗 

分 类 号：R632.5[医药卫生—外科学]