摘要
目的分析胸、腹水标本中的病原菌分布特点及对常用抗菌药物的耐药性,为临床医师抗感染治疗提供参考依据。方法回顾性分析2017年1月1日—2021年12月31日南阳市第一人民医院胸、腹水培养的病原菌分布和耐药性,使用梅里埃Vitek2–Compact自动细菌鉴定药敏仪、珠海迪尔DL-96细菌鉴定分析系统进行菌株鉴定和药敏试验,结果判读参照当年美国临床和实验室标准协会(CLSI)发布的行业标准。结果2074份胸、腹水培养标本,共分离出650株非重复病原菌,总阳性率为31.34%。996份胸水标本中分离出病原菌219株,阳性检出率为21.99%;1078份腹水标本中分离出病原菌431株,阳性检出率为39.98%。胸、腹水分离的病原菌中均以革兰阳性菌为主,分别占55.25%、48.96%,均以肠球菌属和葡萄球菌属为主;革兰阴性菌分别占36.07%、43.62%,主要为大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌;真菌分别占8.68%、7.42%,均以白假丝酵母菌为主。三种主要的革兰阳性球菌对红霉素、青霉素的耐药率高于70.00%,对万古霉素、利奈唑胺和替考拉宁的耐药率为0。大肠埃希菌和肺炎克雷伯菌对氨苄西林、头孢唑林的耐药率最高,超出80.00%,大肠埃希菌对亚胺培南、美罗培南的耐药率低于3.00%,肺炎克雷伯菌对亚胺培南、美罗培南的耐药率高于25.00%,仅对替加环素、多黏菌素B较敏感;鲍曼不动杆菌对亚胺培南、美罗培南的耐药率高于40.00%,但对头孢哌酮/舒巴坦、替加环素比较敏感。结论胸、腹腔感染的病原菌复杂多样,以革兰阳性菌为主,常见病原菌的耐药情况相当严重。明确胸、腹腔感染的病原菌类别和耐药情况,对于临床医师的早期经验性抗感染治疗和医院感染的管控有极其重要的指导意义。
Objective To provide a reference for physicians for anti-infection treatment and to assess the distribution characteristics of pathogens in pleural effusion and ascites samples as well as their resistance to routinely used antibacterial agents.Methods The distribution and drug resistance of pathogenic bacteria cultured in pleural and abdominal water of Nanyang First People's Hospital from January 1,2017,to December 31,2021 were retrospectively analyzed.The bacterial strains were identified and tested with Meriere Vitek2-Compact automatic bacterial identification and drug sensitivity analyzer and Zhuhai Deere DL-96 bacterial identification and analysis system.The results were interpreted according to the industry standards issued by American clinical and laboratory standards institute(CLSI).Results A total of 650 strains of non-repeated pathogens were isolated from 2074 specimens of pleural and ascites,with a total positive rate of 31.34%.219 strains of pathogenic bacteria were isolated from 996 samples of pleural effusion,and the positive detection rate was 21.99%.431 strains of pathogenic bacteria were isolated from 1078 ascites samples,and the positive detection rate was 39.98%.The main pathogens isolated from hydrothorax and ascites were Gram-positive bacteria,accounting for 55.25% and 48.96%,respectively.The two primary pathogens were Staphylococcus and Enterococcus.Gram-negative bacteria accounted for 36.07%and 43.62%,respectively,mainly Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumanni;fungi accounted for 8.68% and 7.42%,respectively,and Candida albicans predominant.The resistance rates of the three main Gram-positive cocci to erythromycin and penicillin were higher than 70.00%,and the resistance rates to vancomycin,linezolid and teicoplanin were 0.00%.Only tigecycline and polymyxin B were sensitive;Escherichia coli and Klebsiella pneumoniae had the highest drug resistance rates to ampicillin and cefazolin,more than 80.00%;Escherichia coli had the lowest drug resistance rates to imipenem and
作者
王灿灿
王莹
桑原锋
矫杨
Wang Can-can;Wang Ying;Sang Yuan-feng;Jiao Yang(Department of Clinical Laboratory,Nanyang First People's Hospital,Nanyang 473000)
出处
《国外医药（抗生素分册）》
CAS
2023年第4期252-255,共4页
World Notes on Antibiotics
关键词
胸水
腹水
病原菌
耐药性
腹腔感染
药敏试验
hydrothorax
ascites
pathogenic bacteria
drug resistance
abdominal infection
susceptibility testing
