摘要
目的了解医院与社区获得性腹腔感染的病原菌特征,为临床抗菌药物治疗提供指导依据。方法根据医院2009年1月-2011年12月临床送检的腹腔穿刺或引流液细菌培养阳性标本,回顾性分析242例腹腔感染患者的临床资料及病原学特点。结果医院获得性腹腔感染134例,其中混合感染52例,占38.8%;社区获得性感染108例,其中混合感染27例,占25.0%,医院获得性感染中混合感染的比例高于社区感染,差异有统计学意义(P<0.05);无论是医院获得性还是社区获得性感染,大肠埃希菌均是分离率最高的病原菌;非发酵菌医院获得性感染患者检出49株占24.0%,社区获得性感染菌患者检出19株占13.4%,非发酵菌的分离率医院获得性感染高于社区获得性感染,差异有统计学意义(P<0.05);医院获得性感染肺炎克雷伯菌、产酸克雷伯菌、大肠埃希菌及奇异变形菌的产超广谱β-内酰胺酶(ESBLs)检出率81.8%,高于社区获得性感染的51.2%,差异有统计学意义(P<0.05)。结论医院与社区获得性感染菌株分布及病原菌耐药性有所不同,临床治疗腹腔感染应充分考虑感染的种类并结合相关监测数据进行抗菌药物治疗。
OBJECTIVE To investigate the etiological characteristics of patients with hospital-acquired or community- acquired abdominal infections so as to guide the clinical drug therapy. METHODS The abdominal puncture drainage fluid specimens with bacterial culture positive, which were submitted from Jan 2009 to Dec 2011, were collected, then the clinical data and the etiological characteristics of 242 patients with abdominal infections were retrospectively analyzed. RESULTS Of totally 134 cases of hospital-acquired abdominal infections, there were 52 （38.8%） cases of mixed infections; of totally 108 cases of community-acquired abdominal infections, there were 27 （25.0%） cases of mixed infections, the incidence rate of the mixed infections was higher among the cases of hospital-acquired infections than among the cases of community-acquired infections, the difference was significant （P〈0. 05）. Escherichia coli was the predominant species of pathogen causing either the hospital-acquired infections or the community-acquired infections; there were 49 （24. 0%） strains of non-fermenting bacteria isolated from the cases of hospital-acquired infections, 19 （13.4 %） strains from the cases of community-acquired infections, the difference in the isolation rate of the non-fermenting bacteria was significant （P〈0. 05）; the detection rate of extended-spectrum β-lactarnases（ESBLs）-producing E. coli, Klebsiella pneumoniae , Proteus mirabilis , or Klebsiella oxytoca was 81.8% among the cases of hospital-acquired infections, significantly higher than 51.2% among the cases of community-acquired infections, the difference was significant （P〈0.05）. CONCLUSION The pathogenic bacteria causing the hospltal^acquired infections differ with the strains causing community-acquired infections in the distribution and drug resistance; it is recommended that the clinical treatment of abdominal infections should be preformed based on full consideration of species of the pathogens combined with relevant surveillan
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第22期5585-5587,共3页
Chinese Journal of Nosocomiology
基金
军队"十二五"重大基金资助项目(AWS11C001)
解放军总医院苗圃基金(12KMM03)
关键词
腹腔感染
医院获得性
社区获得性
病原菌
耐药
Abdominal infection
Hospital-acquired
Community-acquired
Pathogen
Drug resistance
