摘要
目的了解哺乳期急性化脓性乳腺炎致病菌的分布特征及对常规抗菌药物的耐药谱,为临床治疗提供依据。方法收集2016年1月至2018年12月在西北妇女儿童医院乳腺科因急性化脓性乳腺炎就诊的253例患者的乳腺穿刺脓液进行培养。采用VITEK-2 COMPACT全自动微生物鉴定药敏仪器进行细菌鉴定,并进行药物敏感性实验和表型筛查试验。结果 253例标本共分离出130株致病菌,检出率为51.4%,2016至2018年检出率呈逐年递增趋势(χ^2=6.191,P<0.05);致病菌以金黄色葡萄球菌为主(95.4%),其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率为25.8%,2016至2018年MRSA检出率呈逐年增长趋势(χ^2=11.560,P<0.05);药敏结果提示金黄色葡萄球菌对青霉素、红霉素、克林霉素耐药率较高,分别为90.3%、73.4%和71.0%,对苯唑西林、四环素、甲氧苄啶/磺胺甲恶唑、庆大霉素耐药率较低,分别为25.0%、19.4%、4.8%和1.6%;对红霉素耐药的分离株中,51株(56.0%)为组成型耐药(cMLSB),35株(38.5%)为诱导型耐药(iMLSB),5株(5.5%)为M型耐药,无L型耐药菌株。结论金黄色葡萄球菌是引起哺乳期急性化脓性乳腺炎的主要致病菌,且MRSA检出率呈逐年上升趋势。金黄色葡萄球菌对青霉素、红霉素、克林霉素耐药率较高,且红霉素耐药菌株中iMLSB表型占一定比率,临床医生应根据药敏结果合理使用抗菌药物进行治疗。
Objective To investigate distribution and drug resistance of pathogenic bacteria to conventional antibiotics in acute suppurative mastitis of breast feeding women,so as to provide basis for treatment of the disease in clinic.Methods The puncture pura from breast abscesses of 253 women with acute suppurative mastitis who admitted to Department of Mastosis of Northwest Women and Children’s Hospital from January 2016 to December 2018 were cultured.VITEK-2 COMPACT automatic microbiological assay and drug sensitivity instrument were used to identify the bacteria,conduct drug sensitivity test and phenotype screening test.Results A total of 130 pathogenic bacteria were isolated from 253 specimens and the detection rate was 51.4%.From 2016 to 2018,the detection rate of pathogenic bacteria showed an increasing trend year by year(χ^2=6.191,P<0.05).Staphylococcus aureus was the main pathogen(95.4%).The detection rate of methicillin-resistant Staphylococcus aureus(MRSA) was 25.8%,which also showed an increasing trend year by year from 2016 to 2018(χ^2=11.560,P<0.05).Drug susceptibility results showed that the resistance rates of Staphylococcus aureus to penicillin,erythromycin and clindamycin were higher as 90.3%,73.4% and 71.0% respectively.While the resistance rates of Staphylococcus aureus to oxacillin,tetracycline,trimethoprim/sulfamethoxazole and gentamicin were lower as 25.0%,19.4%,4.8% and 1.6% respectively.Among the isolated strains resistant to erythromycin,51 strains(56.0%) were constitutive resistance(cMLSB),35 strains(38.5%) were induced resistance(iMLSB),5 strains(5.5%) were M-type resistance and no L-type resistant strains were detected.Conclusion Staphylococcus aureus is the main pathogen of acute suppurative mastitis in lactation period,and the detection rate of MRSA shows an increasing tendency year by year.In our study,Staphylococcus aureus presents highly resistant to penicillin,erythromycin and clindamycin,and iMLSB phenotype accounts for a certain proportion of erythromycin-resistant strains.Clinicia
作者
王丽滨
杨柳
屈蕾
孟改利
杨军兰
谢云
武冬娜
WANG Libin;YANG Liu;QU Lei;MENG Gaili;YANG Junlan;XIE Yun;WU Dongna(Department of Clinical Laboratory,Northwest Womenand Children's Hospital,Shaanxi Xi'an 710061,China)
出处
《中国妇幼健康研究》
2020年第8期1030-1034,共5页
Chinese Journal of Woman and Child Health Research
基金
陕西省科技厅自然科学基础研究计划项目(编号:2016JQ8058)。
关键词
哺乳期
急性乳腺炎
致病菌
耐药性
lactation period
acute mastitis
pathogenic bacteria
drug resistance
