摘要
目的:通过分析青岛大学附属医院化脓性肝脓肿患者的细菌培养及药敏结果、基础疾病、临床特点、治疗方法及预后情况,总结该地区化脓性肝脓肿患者的特点,为早期诊断及早期用药提供理论依据。方法:回顾性收集青岛大学附属医院2017年9月至2022年9月收治的124名住院诊断为肝脓肿患者的临床资料,根据细菌培养结果,分为肺炎克雷伯菌组(KP-PLA组)和大肠埃希菌组(EC-PLA组),并进一步将肺炎克雷伯菌组分为耐药组(DKP-PLA)和普通组(KP-PLA),分别比较肺炎克雷伯菌组和大肠埃希菌组的临床特点,及肺炎克雷伯菌组内,耐药组和非耐药组的特点。结果:在对124例肝脓肿患者的临床特点分析中,男性多于女性,男女比例2.0:1.0,且以右侧肝脓肿为主例(63.7%);在124例脓液细菌培养阳性的患者标本中,普通肺炎克雷伯菌106例,耐药肺炎克雷伯6例,大肠埃希菌8例,粪肠球菌3例,链球菌2例,金葡菌2例,其他菌株6例。获得单一细菌培养结果117例,多细菌培养结果7例;药敏结果提示:普通肺炎克雷伯杆菌对哌拉西林他唑巴坦敏感率100%,耐药肺炎克雷伯杆菌对亚胺培南敏感率及哌拉西林他唑巴坦敏感率较高(83.33%),大肠埃希菌对亚胺培南敏感率较高(87.5%);在对肺炎克雷伯杆菌肝脓肿的感染危险因素分析时,得出了有统计学意义的1个因素,即:饮酒,有饮酒史的患者史患细菌性肝脓肿的可能性是其他患者的9倍。结论:化脓性肝脓肿患者临床症状较为典型,其主要致病菌为肺炎克雷伯菌,其次为大肠埃希菌,这与其他地区机构的回顾分析一致。抗感染联合穿刺引流是我院主要的治疗方式,临床治愈效果显著,极大的改善了患者的预后。
Objective: To explore the bacterial culture and drug susceptibility results, underlying diseases, clinical characteristics, treatment methods and prognosis of patients with pyogenic liver abscess in Qingdao University Affiliated Hospital, and to provide a theoretical basis for early diagnosis and early treatment. Methods: The clinical data of 124 patients with pyogenic liver abscess admitted to the Affiliated Hospital of Qingdao University from September 2017 to September 2022 were retrospectively collected, and according to the bacterial culture results, they were divided into Klebsiella pneumoniae group (KP-PLA group) and Escherichia coli group (EC-PLA group), and the Klebsiella pneumoniae group was further divided into drug resistance group (DKP-PLA) and ordinary group (KP-PLA group), then the clinical characteristics of Klebsiella pneumoniae group and Escherichia coli group were compared. The characteristics of the drug-resistant and non-resistant groups in the Klebsiella pneumoniae group were also compared. Results: Among 124 cases of patients with liver abscess, there were more males than females, with a male-to-female ratio of 2.0:1.0, and the majority (63.7%) of them suffered from right-sided liver abscess. Among 124 cases of positive bacterial cultures from pus samples, there were 106 cases of Klebsiella pneumoniae, 6 cases of drug-resistant Klebsiella pneumoniae, 8 cases of Escherichia coli, 3 cases of Enterococcus faecalis, 2 cases of Streptococcus, 2 cases of Staphylococcus aureus, and 6 cases of other strains. 117 cases had single bacterial culture results, and 7 cases had multiple bacterial culture results. Drug sensitivity results showed that the sensitivity rate of Klebsiella pneumoniae to piperacillin/tazobactam was 100%, and the sensitivity rates of drug-resistant Klebsiella pneumoniae to imipenem and piperacillin/tazobactam were high (83.33%), while Escherichia coli had a high sensitivity rate to imipenem (87.5%). In the analysis of risk factors for Klebsiella pneumoniae liver abscess infection
出处
《临床医学进展》
2024年第6期459-466,共8页
Advances in Clinical Medicine
