检验医学与临床
檢驗醫學與臨床
검험의학여림상
JOURNAL OF LABORATORY MEDICINE AND CLINICAL SCIENCES
2015年
4期
439-440,443
,共3页
腹水%病原菌%耐药性
腹水%病原菌%耐藥性
복수%병원균%내약성
ascites%pathogenic bacteria distribution%antibiotic resistance
目的：检测重庆医科大学附属第一医院2011～2013年腹水标本中的细菌学分布，并对其进行耐药性分析，以探讨腹水标本的细菌学分布和耐药性特点，为临床经验性用药提供指导。方法收集重庆医科大学附属第一医院2011～2013年临床送检的腹水标本细菌培养报告，对病原菌的分布特征和药敏试验资料进行回顾性分析。结果从1308例腹水标本中，230例分离出了病原菌，标本阳性率为18．31％。共检出病原菌282株，其中革兰阴性菌占56．0％，主要是大肠埃希菌和肺炎克雷伯菌；其次为革兰阳性菌占38．3％，以屎肠球菌、粪肠球菌和表皮葡萄球菌为主。大肠埃希菌对环丙沙星、头孢曲松等耐药，肺炎克雷伯菌对氨苄西林／舒巴坦、复方磺胺甲噁唑等耐药，屎肠球菌对红霉素、克林霉素等多种抗菌药物耐药，粪肠球菌对克林霉素、奎奴普丁／达福普汀等耐药。大肠埃希菌中产超广谱β‐内酰胺酶菌株的耐药性普遍高于不产超广谱β‐内酰胺酶的菌株。结论加强腹水标本的细菌学检查，依据药敏试验合理使用抗菌药物，对腹腔感染的诊断与治疗具有重要价值。
目的：檢測重慶醫科大學附屬第一醫院2011～2013年腹水標本中的細菌學分佈，併對其進行耐藥性分析，以探討腹水標本的細菌學分佈和耐藥性特點，為臨床經驗性用藥提供指導。方法收集重慶醫科大學附屬第一醫院2011～2013年臨床送檢的腹水標本細菌培養報告，對病原菌的分佈特徵和藥敏試驗資料進行迴顧性分析。結果從1308例腹水標本中，230例分離齣瞭病原菌，標本暘性率為18．31％。共檢齣病原菌282株，其中革蘭陰性菌佔56．0％，主要是大腸埃希菌和肺炎剋雷伯菌；其次為革蘭暘性菌佔38．3％，以屎腸毬菌、糞腸毬菌和錶皮葡萄毬菌為主。大腸埃希菌對環丙沙星、頭孢麯鬆等耐藥，肺炎剋雷伯菌對氨芐西林／舒巴坦、複方磺胺甲噁唑等耐藥，屎腸毬菌對紅黴素、剋林黴素等多種抗菌藥物耐藥，糞腸毬菌對剋林黴素、奎奴普丁／達福普汀等耐藥。大腸埃希菌中產超廣譜β‐內酰胺酶菌株的耐藥性普遍高于不產超廣譜β‐內酰胺酶的菌株。結論加彊腹水標本的細菌學檢查，依據藥敏試驗閤理使用抗菌藥物，對腹腔感染的診斷與治療具有重要價值。
목적：검측중경의과대학부속제일의원2011～2013년복수표본중적세균학분포，병대기진행내약성분석，이탐토복수표본적세균학분포화내약성특점，위림상경험성용약제공지도。방법수집중경의과대학부속제일의원2011～2013년림상송검적복수표본세균배양보고，대병원균적분포특정화약민시험자료진행회고성분석。결과종1308례복수표본중，230례분리출료병원균，표본양성솔위18．31％。공검출병원균282주，기중혁란음성균점56．0％，주요시대장애희균화폐염극뢰백균；기차위혁란양성균점38．3％，이시장구균、분장구균화표피포도구균위주。대장애희균대배병사성、두포곡송등내약，폐염극뢰백균대안변서림／서파탄、복방광알갑오서등내약，시장구균대홍매소、극림매소등다충항균약물내약，분장구균대극림매소、규노보정／체복보정등내약。대장애희균중산초엄보β‐내선알매균주적내약성보편고우불산초엄보β‐내선알매적균주。결론가강복수표본적세균학검사，의거약민시험합리사용항균약물，대복강감염적진단여치료구유중요개치。
Objective To investigate the bacterial distribution characteristic and antibiotic resistance of patho‐gens isolated from ascitic specimens in the First Affiliated Hospital of Chongqing Medical University from 2011 to 2013 .Methods The bacterial culture and drug sensitivity test data of bacterial isolated from clinical ascites specimens from 2011 to 2013 were analyzed retrospectively .Results A total of 282 pathogenic bacteria strains were found in 230 cases of 1 308 ascites specimens ,the positive rate was 18 .31% .There were 282 strains of bacterial isolated ,and morethanhalf of them were Gramnegativebacteria (56.0% ),Escherichiacoli(E.coli),Klebsiellapneumoniaewere the main bacteria .38 .3% of them were Gram positive bacteria ,Enterococcus faecium ,Enterococcus faecalis and Staphylococcus epidermidis were the main Gram‐positive bacteria .E .coli showed high resistant to ciprofloxacin and ceftriaxone .Klebsiella pneumoniae showed high resistant to ampicillin/shu ba jotham and compound sulfamethox‐azole .Enterococcus faecium showed high resistant to erythromycin clindamycin .Enterococcus faecalis showed high resistant to clindamycin ,quinupristin/dalfopristin .The drug resistant of super broad spectrum beta lactamase strain of E .coli was significant higher than that of E .coli didn′t produce the ultra broad spectrum beta lactamase strains . Conclusion The bacteria culture of ascitic specimens should be strengthened ,and antibacterial agents should be se‐lected according to the result of drug sensitivity test .
