CAJ | 학술논문

目的了解舟山海岛地区肛瘘患者脓液中的病原菌谱及其耐药特点.方法回顾性分析2010年1月至2014年6月在舟山医院住院的1 32例肛瘘患者脓液病原菌谱及药敏结果,应用x2检验及Logistic回归分析方法对检出的病原菌谱及药敏结果进行统计学处理.结果 132例患者的肛瘘脓液中,病原菌培养阳性的69例,阳性率52.27％ (69/132),其中混合感染2例;大肠埃希菌46株占64.79％(46/71),其中产超广谱β-内酰胺酶(extended spectrum β-lactamases,ESBLs)的大肠埃希菌19株占41.30％(19/46);阴沟肠杆菌和肺炎克雷伯菌各5株占7.04％(5/71).大肠埃希菌对美洛培南、阿米卡星、亚胺培南、哌拉西林/他巴唑坦的敏感性较高(耐药率均＜10％),对其他药物的敏感性较低(耐药率均＞28％);产ESBLs大肠埃希菌对非β-内酰胺类抗生素如四环素、哌拉西林/他巴唑坦、氯霉素、环丙沙星、左旋氧氟沙星的耐药率较非产ESBLs大肠埃希菌高,差异有统计学意义(P＜0.05).结论舟山海岛地区肛瘘患者脓液中,以大肠埃希菌感染为主,产ESBLs大肠埃希菌比例较高,对多种抗生素耐药率较非产ESBLs大肠埃希菌高,需引起重视.
목적 료해주산해도지구항루환자농액중적병원균보급기내약특점.방법 회고성분석2010년1월지2014년6월재주산의원주원적1 32례항루환자농액병원균보급약민결과,응용x2검험급Logistic회귀분석방법대검출적병원균보급약민결과진행통계학처리.결과 132례환자적항루농액중,병원균배양양성적69례,양성솔52.27％ (69/132),기중혼합감염2례;대장애희균46주점64.79％(46/71),기중산초엄보β-내선알매(extended spectrum β-lactamases,ESBLs)적대장애희균19주점41.30％(19/46);음구장간균화폐염극뢰백균각5주점7.04％(5/71).대장애희균대미락배남、아미잡성、아알배남、고랍서림/타파서탄적민감성교고(내약솔균＜10％),대기타약물적민감성교저(내약솔균＞28％);산ESBLs대장애희균대비β-내선알류항생소여사배소、고랍서림/타파서탄、록매소、배병사성、좌선양불사성적내약솔교비산ESBLs대장애희균고,차이유통계학의의(P＜0.05).결론 주산해도지구항루환자농액중,이대장애희균감염위주,산ESBLs대장애희균비례교고,대다충항생소내약솔교비산ESBLs대장애희균고,수인기중시.
Objective To investigate the spectrum of pathogens in the pus of anal fistula patients in Zhoushan offshore areas and features of antibiotic resistance of pathogens.Methods The spectrum of pathogens in the pus of 132 anal fistula patients admitted into the Zhoushan Hospital from January 2010 to June 2014 and drug sensitivity were analyzed retrospectively.Then,statistical analyses were made in the spectrum of pathogens and drug sensitivity results by using chi-square test and Logistic regression.Results Pathogenic detection in the pus of 132 anal fistula patients revealed that 69 eases were positive,with a positive rate of 52.27％ (69/132),of which 2 cases were mixed infection.From the isolated bacteria,it was indicated that E.coli accounted for 64.79％ (46/71),of which 19 strains of ESBLs-producing E.coli accounted for 41.30％ (19/46).There were 5 strains of enterobaeter cloacae and klebsiella pneumonia,which accounted for 7.04％ (5/71).E.coli was relatively more sensitive to meropenem,amikacin,imipenem and piperacillintazobactam,with drug resistance rates lower than 10％.But,E.coli was less sensitive to other drugs with drug resistance rates higher than 28％.The drug resistance rates of ESBLs-producing E.coli to such non-β-lactam antibiotics as tetracycline,piperacillin-tazobactam,chloromycetin,ciprofloxacin and levofloxacin were relatively higher than those of the non-ESBLs-producing E.coli,with statistical significance (P ＜ 0.05).Conclusions Pathologic detection in the pus of anal fistula patients revealed that E.coli was the prevalent bacteria,with ESBLs-producing E.coli accounting for a relatively high rate,and drug resistance rates to various antibiotics were obviously higher than those of the non-ESBLs-producing E.coli,to which greater attention should be paid.