摘要
目的:分析肛周脓肿患者的病原菌结构和其耐药情况,为临床抗菌药物的选择提供依据。方法:收集医院2019年1月~2020年12月期间收治的324例肛周脓肿患者的脓液标本,在实验室进行菌株的培养、鉴定及药敏试验,记录并分析结果。结果:324例患者均送检标本共分离出病原菌516株,其中革兰阴性菌421株,占81.59%;革兰阳性菌95株,占18.41%。421株革兰阴性菌中,以大肠埃希菌的检出率最高,其次是肺炎克雷伯菌;95株革兰阳性菌中金黄色葡萄球菌检出率最高。在革兰阴性菌中,大肠埃希菌整体耐药率较高,其对氨苄西林、头孢吡肟的耐药率均超过60.00%;肺炎克雷伯菌的耐药率相对较低,仅对头孢曲松、氨苄西林的耐药率超过30.00%。在革兰阳性菌中,金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌对氨苄青霉素、红霉素、环丙沙星和左氧氟沙星的耐药率均较高,超过50%,同时三种葡萄球菌均未检出万古霉素和利奈唑胺的耐药菌株。结论:肛周脓肿患者的病原菌以革兰阴性菌为主,大多为大肠埃希菌和肺炎克雷伯菌,病原菌对不同抗菌药物的耐药性差异较大,应根据药敏结果合理选用抗菌药物。
Objective:To analyze the pathogenic bacteria structure and drug resistance in patients with perianal abscess,so as to provide the basis for the selection of clinical antibacterial agents.Methods:The purulent fluid specimen of 324 patients with perianal abscess who treated in our hospital from January 2019 to December 2020 were selected,the culture,identification and drug sensitivity test of strains were carried out in the laboratory,and the results were recorded and analyzed.Results:A total of 516 strains of pathogenic bacteria were isolated from 324 patients,there were 421 strains of Gram-negative bacteria,accounting for 81.59%,and 95 strains of Gram-positive bacteria,accounting for 18.41%.Among 421 strains of gram negative bacteria,Escherichia coli had the highest detection rate,followed by Klebsiella pneumoniae.The detection rate of Staphylococcus aureus was the highest among 95 strains of gram positive bacteria.Among Gram-negative bacteria,Escherichia coli had a high overall resistance rate,the resistance rates to ampicillin and cefepime were more than 60.00%.The drug resistance rate of Klebsiella pneumoniae was relatively low,only ceftriaxone,ampicillin resistance rate of more than 30%.Among the Gram-positive bacteria,Staphylococcus aureus,Staphylococcus epidermidis and Staphylococcus haemolyticus had higher resistance rates to ampicillin,erythromycin,ciprofloxacin and levofloxacin,more than 50%,vancomycin and linezolid resistant strains were not detected in the three kinds of Staphylococcus at the same time.Conclusion:Most of the pathogens in patients with perianal abscess are Gram-negative bacteria,most of them are Escherichia coli and Klebsiella pneumoniae.The drug resistance of pathogens to different antibiotics varies greatly.Therefore,antibiotics should be selected reasonably according to the results of drug sensitivity.
作者
黄世萍
丁康
薛雅红
曹磊
孙跃明
HUANG Shi-ping;DING Kang;XUE Ya-hong;CAO Lei;SUN Yue-ming(Department of Colorectal Surgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210000,China;Department of Anorectal,Nanjing Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu,210000,China)
出处
《现代生物医学进展》
CAS
2021年第21期4087-4090,4175,共5页
Progress in Modern Biomedicine
基金
江苏省科技计划项目(BK20201491)。
关键词
肛周脓肿
革兰阴性菌
大肠埃希菌
肺炎克雷伯菌
金黄葡萄球菌
耐药性
Perianal abscess
Gram negative bacteria
Escherichia coli
Klebsiella pneumoniae
Staphylococcus aureus
Drug resistance
