腹腔感染病原菌及其耐药性
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杨兴祥

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R181.3+2R378

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Distribution and antimicrobial resistance of pathogens causing intraabdominal infection
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    摘要:

    目的了解腹腔感染病原菌构成及其耐药性,为临床腹腔感染的治疗提供参考依据。方法对某院2011年1月—2013年12月住院患者送检的腹腔感染标本进行菌种鉴定及药物敏感性检测,并将数据输入WHONET 5.6软件进行统计分析。结果15 946份腹腔感染标本分离非重复病原菌810株,培养阳性率5.08%;革兰阴性杆菌485株(59.88%),革兰阳性菌275株(33.95%),真菌50株(6.17%);居前5位的病原菌分别为大肠埃希菌(24.20%)、屎肠球菌(15.06%)、鲍曼不动杆菌(8.89%)、肺炎克雷伯菌(7.66%)和凝固酶阴性葡萄球菌(6.91%)。产超广谱β内酰胺酶(ESBLs) 大肠埃希菌和肺炎克雷伯菌检出率分别为59.18%和32.79%,各种肠杆菌科细菌对亚胺培南仍高度敏感,但对碳青霉烯类耐药的菌株占4.08%~6.67%;多重耐药鲍曼不动杆菌占52.11%(37/71),耐甲氧西林金黄色葡萄球菌(MRSA) 占53.57%(15/28),耐甲氧西林凝固酶阴性葡萄球菌(MRCNS) 占71.43%(40/56),耐万古霉素屎肠球菌(VRE) 占8.26%。结论该院腹腔感染病原菌主要是以大肠埃希菌为代表的革兰阴性菌,屎肠球菌是最常见革兰阳性致病菌,细菌耐药形势严峻。

    Abstract:

    ObjectiveTo understand the constituent and antimicrobial  resistance of pathogens causing intraabdominal infection,  so as to provide reference for clinical treatment of intraabdominal infection.MethodsPathogens causing intraabdominal infection in patients in a hospital from January 2011 to December 2013 were identified and performed antimicrobial susceptibility testing, and results were  analyzed with WHONET5.6 software.ResultsA total of 810 nonrepeated strains were isolated from 15 946 intraabdominal specimens, isolation rate was 5.08%; isolation rates of gramnegative bacilli, grampositive bacteria, and fungi were  59.88%(n=485), 33.95% (n=275), and 6.17%(n=50) respectively;  the top five pathogens were Escherichia coli (E. coli,24.20%), Enterococcus faecium (E. faecium, 15.06%), Acinetobacter baumannii (A. baumannii, 8.89%), Klebsiella pneumoniae (K. pneumoniae, 7.66%), and coagulase negative staphylococcus (CNS, 6.91%). The detection rates of extendedspectrum β1actamases(ESBLs) in E. coli and K. pneumoniae were 59.18% and 32.79% respectively. Enterobacteriaceae were still highly sensitive to imipenem, but carbapenemresistant Enterobacteriaceae strains accounted for 4.08%-6.67% ; multidrugresistant A. baumannii accounted for  52.11%(37/71), methicillinresistant strains in Staphylococcus aureus and CNS accounted for 53.57%(15/28) and 71.43%(40/56) respectively, resistance rate of E. faecium to vancomycin was 8.26%.ConclusionThe main pathogens causing intraabdominal infection in this hospital are gramnegative bacilli, especially E. coli, while E. faecium is the most common grampositive pathogen, antimicrobial resistance of bacteria is still serious.

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引用本文

黄仁刚,杨兴祥,喻华,等.腹腔感染病原菌及其耐药性[J]. 中国感染控制杂志,2015,14(11):761-765. DOI:10.3969/j. issn.1671-9638.2015.11.011.
HUANG Rengang, YANG Xingxiang, YU Hua, et al. Distribution and antimicrobial resistance of pathogens causing intraabdominal infection[J]. Chin J Infect Control, 2015,14(11):761-765. DOI:10.3969/j. issn.1671-9638.2015.11.011.

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  • 收稿日期:2015-01-20
  • 最后修改日期:2015-03-21
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  • 在线发布日期: 2015-11-30
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