成人急性阑尾炎患者腹腔病原菌变迁及耐药分析

Analysis of bacteria vicissitudes and drug resistance in abdominal cavity of adult with acute appendicitis

目的研究成人急性阑尾炎患者腹腔病原菌变迁及耐药分析。方法对168例急性阑尾炎患者腹腔渗出物进行细菌培养、鉴定及药敏试验,回顾性分析培养阳性的191株需氧菌及药敏结果。结果分离菌中革兰阴性菌占72.3%,革兰阳性菌占27.2%,需氧菌的混合感染达14.3%。近7年来革兰阴性条件致病菌、凝固酶阴性葡萄球菌及耐甲氧西林葡萄球菌分离率上升,革兰阴性菌对第三代头孢菌素的耐药率在29.5%以上,β-内酰胺酶抑制剂与第三代头孢菌素的复合物仍有较高的抑菌率,在94.4%以上。革兰阳性菌最敏感的药物仍为去甲万古霉素,本组检测到1例耐万古霉素肠球菌(占8.3%)。结论成人急性阑尾炎患者腹腔病原菌在变迁,病原菌对临床常用抗生素的耐药率在增高。

[Objective] To study bacteria vicissitudes and analysis of bacteria vicissitudes and drug resistance in cavity of adult appendicitis. [Method] To culture, indentffy and test bacteria from the abdominal cavity effusion in 168 adult patients and analyze 191 oxybiontic with positive culture and their drug-resistance ability. [Result] Infection rate of Gram-negative bacteria was 72.3% and Gram-positive bacteria was 27.2% and oxybiontic bacteria polyinfection was 14.3% in all separated bacterium. In recent 7 years, isolating rates of Gram negative opportunistic pathogen, coagulase negative staphylococcus and fast-meticillin sodium Staph; staphylococci have rised, the rate of drug fast was over 29.5% Gram-negative bacteria to ter-cephalosporin, the mixture of β-lactamase inhibitor and ter-cephalosporin has bacteriostasis rate as high as 94.4%. The most sensitive drug of Gram-positive bacteria was still Norvancomycin. We just has detected one patient to resist vancomycin （namely 8.3%）. [Conclusion] Abdominal cavity pathogenic bacterium is diversifying in adult with acute appendicitis. Their drug-resistance ability to common antibiotics is increasing.