肛周脓肿患者脓培养中的病原菌分布及对抗菌药物的药敏分析  

Distribution of Pathogenic Bacteria and Antimicrobial Susceptibility Analysis in Pus Culture of Patients with Perianal Abscess

作　　者：石瑞瑞 丁康[2] 谭妍妍[2] SHI Ruirui;DING Kang;TAN Yanyan(Nanjing University of Chinese Medicine,Nanjing 210023,China;不详)

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属南京中医院肛肠科,江苏南京210022

出　　处：《中国医学创新》2025年第9期150-154,共5页Medical Innovation of China

基　　金：江苏省基础研究计划自然科学基金项目(BK20221178);江苏省中医肛肠疾病临床医学创新中心重点项目(GCCXZX-2021);江苏省中医药科技发展计划一般项目(YB2020029);江苏省研究生实践创新计划项目(SJCX23_0917)。

摘　　要：目的:了解肛周脓肿患者脓液培养中的病原菌分布及药物敏感情况。方法:随机抽调南京中医药大学附属南京中医院肛肠科于2023年1月—2024年3月收治的264例肛周脓肿患者的脓液培养结果,以及培养菌的药敏结果,进行回顾性分析,观察病原菌的分布特点及药敏情况。结果:264例患者中脓液培养结果为阳性的总共220例(83.3%),其中171例脓液培养结果提示感染1种菌株,46例提示感染2种菌株,3例提示感染3种菌株。共检出病原菌272株,革兰阴性菌216株(79.41%),革兰阳性菌56株(20.59%)。革兰阴性菌以大肠埃希菌(46.32%)、肺炎克雷伯菌(21.69%)、奇异变形杆菌(4.78%)为主。对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢西丁、美罗培南、亚胺培南、阿米卡星敏感率均达90%以上。革兰阳性菌以中间链球菌(6.99%),咽峡炎链球菌(2.57%),金黄色葡萄球菌(1.84%)为主。对左氧氟沙星、利奈唑胺、万古霉素敏感率均达80%以上。264例肛周脓肿患者术后形成肛瘘并于本院行2次手术者共27例,以大肠埃希菌感染为主。结论:大肠埃希菌是病灶部位常见的菌种,药敏结果对抗感染治疗有一定的指导意义,需结合临床使用,在肛周脓肿发病中的作用需更深入的研究加以说明。Objective:To understand the distribution of pathogenic bacteria and drug sensitivity in pus culture of patients with perianal abscess.Method:A retrospective analysis was conducted on the results of pus culture and drug sensitivity of 264 patients with perianal abscess admitted to the Colorectal Department of Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2023 to March 2024.The distribution characteristics and drug sensitivity of pathogenic bacteria were observed.Result:Among the 264 patients,a total of 220 cases(83.3%)were showed positive results in pus culture.Among them,171 cases were showed infection with one bacterial strain,46 cases were showed infection with two bacterial strains,and 3 cases were showed infection with three bacterial strains.A total of 272 pathogenic bacteria were detected,including 216 Gram negative bacteria(79.41%)and 56 Gram positive bacteria(20.59%).Gram negative bacteria were mainly Escherichia coli(46.32%),Klebsiella pneumoniae(21.69%),and Proteus mirabilis(4.78%).The sensitivity rates to Piperacillin/Tazobactam,Cefoperazone/Sulbactam,Cefoxitin,Meropenem,Imipenem,and Amikacin were all over 90%.Gram positive bacteria were mainly Streptococcus mutans(6.99%),Streptococcus pharyngitis(2.57%),and Staphylococcus aureus(1.84%).The sensitivity rates to Levofloxacin,Linezolid and Vancomycin were both over 80%.Among 264 patients with perianal abscess who developed anal fistula after surgery and underwent 2 surgeries in our hospital,a total of 27 cases were mainly infected with Escherichia coli.Conclusion:Escherichia coli is a common bacterial strain at the site of lesions,and drug sensitivity results have certain guiding significance for the treatment of infections.It needs to be combined with clinical use,and its role in the pathogenesis of perianal abscesses needs to be further studied and explained.

关 键 词：肛周脓肿 病原菌分布 抗生素敏感率 肛瘘 

分 类 号：R44[医药卫生—诊断学]