摘要
目的分析腹部创伤并严重腹腔感染患者的腹腔脓液细菌菌群分布及体外药物敏感情况。方法2001年1月至2012年5月南京军区南京总医院全军普通外科研究所收治的腹部创伤并发严重腹腔感染病例41例，获得腹腔脓液标本共123份，回顾性分析微生物实验室菌群及药敏结果，输入WHONET5．4软件进行耐药性分析。结果41例患者腹腔脓液标本共分离出297株菌，平均（7．2±2．3）株。革兰阳性细菌占44．1％（131／297），革兰阴性细菌占55．2％（164／297），真菌占0．7％（2／297）。分离率前5位的细菌依次为大肠埃希菌（72株，24．2％）、金黄色葡萄球菌（66株，22．2％）、肺炎克雷伯菌（34株，11．4％）、粪肠球菌（28株，9．4％）和铜绿假单胞菌（21株，7．1％）。大肠埃希菌对头孢哌酮和亚胺培南的敏感率较高，均超过90％，分别为9l％和98％。革兰阳性球菌对替考拉宁和利奈唑胺的敏感率均为100％，金黄色葡萄球菌对万古霉素敏感率为100％。肺炎克雷伯菌对亚胺培南的敏感率为100％、对阿米卡星的敏感率为79％。铜绿假单胞菌对环丙沙星敏感率最高（90％）。结论腹部创伤并严重腹腔感染患者腹腔感染菌尽管以革兰阴性菌为主，但革兰阳性菌，特别是金黄色葡萄球菌感染比例也较高；头孢哌酮、环丙沙星、亚胺培南、万古霉素、替考拉宁、利奈唑胺具有较高的抗菌活性。
Objective To retrospectively analyze the bacteriological spectrum and drug susceptibility of pus flora from abdominal traumatic patients with severe intra-abdominal infection. Methods A total of 41 severe intra-abdominal infected patients with abdominal trauma were recruited to collect 123 abdominal pus specimens. And the results of laboratory microbiology and drug sensitivity were analyzed with the WHONET 5.4 software. Results A total of 297 strains of bacteria were isolated at （7.2 ± 2. 3 ） strains for each patient. Gram-positive bacteria accounted for 44. 1% （ 131/297 ）, Gram-negative bacteria 55.2% （164/297） and fungi 0. 7% （2/297）. The top five isolates were Escherichia coil, Staphylococcus aureus, Klebsiella pneumonia, Enterococcus faecalis and Pseudomonas aeruginosa. Those antibiotics highly sensitive （ 〉90% ） to Escherichia coli included cefoperzone （91%）, imipenem （98%） ; highly sensitive to Gram- positive cocci included teicoplanin （100%） and linezolid （100%）. Staphylococcus aureus was 100% sensitive to vancomycin. The agents with a high susceptibility to Klebsiella pneumonia included imipenem （100%） and amikacin （79%）. Ciprofloxacin （90%） had the highest sensitivity to Pseudomonas aeruginosa. Conclusions The predominant bacteria of causing severe intra-abdominal infection of traumatic patients is Gram-negative bacteria, but the infection of Gram-positive bacteria, especially the ratio of Staphylococcus aureus infection is also comparatively high. Cefoperazone, ciprofloxaein, imipenem, vancomycin, teicoplanin and linezolid have higherly antibacterial activity.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第32期2567-2570,共4页
National Medical Journal of China
关键词
腹部损伤
细菌学
脓毒症
休克
脓毒性
严重腹腔感染
Abdominal injuries
Bacteriology
Sepsis
Shock, septic
Severe intra- abdominal infection
