儿童阑尾炎感染病原菌的分布及耐药性

Distribution and drug-resistance of pathogenic bacteria in children with appendicitis

目的:研究患阑尾炎儿童感染病原菌的种类、分布特征及抗生素的耐药情况。方法:采取术中阑尾炎脓液标本作培养,利用MicroScan-Wolk/40全自动微生物分析仪进行细菌鉴定和药敏实验。结果:在患阑尾炎儿童感染病原菌中,革兰阴性杆菌以大肠埃希菌、铜绿假单孢菌、肺炎克雷伯菌为主;革兰阳性菌以金黄色葡萄球菌、粪肠球菌、屎肠球菌居多。在药敏实验中,革兰阴性杆菌对亚胺硫霉素耐药率<10%,头孢西丁、环丙氟哌酸耐药率相对较低,金黄色葡萄球菌对万古霉素无耐药株,对亚胺硫霉素、环丙氟哌酸、复方新诺明、利复平、苯唑青霉素耐药率<10%。结论:大肠埃希菌、铜绿假单孢菌、肺炎克雷伯菌、金黄色葡萄球菌、粪肠球菌、屎肠球菌在阑尾腔内繁殖是小儿阑尾炎症的诱发因素之一,对这些病原菌药敏分析的调查,对防治术后切口感染,合理使用抗生素有重要临床意义。

Objective：To investigate the kinds,distribution and antibiotic drug-resistant condition of pathogenic bacteria in children with appendicitis. Methods：303 clinical isolates were separated from pus samples collected during the surgical operations of appendicitis and identified,and their drug sensitivity tests were performed by Microscan-wolk/40.Results：In 303 clinical isolates,the main gramnegetive bacilli included E.coli,P.aemginosa and K.pncumoniac,whilc S. aureus,Ec faccalis and Ec faecium were the main gram-positive cocci. Imipencndcilastatin （ticnam）was below 10% drug-resistance,and ccfoxitin and ciprofloxacin were relative less on grmn-nogctivc bacilli in vitro,S.aureus was no drag-resistance on vancomycin.Imipenendcilastatin （tienam）,ci oxacillin were below 10%drug-resistance.Conclusion：E coli,P.aemginosa,K.pneumoniae,S.aureus,Ec faecalis and Ec faecium propagating in appendix were the main factors of appendicitis attacking.It was very important to investigate the distribution and drug-resistance of pathogenic bacteria in appendicitis for preventing wound infection and guiding the rational use of antibiotics.