小儿急性阑尾炎脓液细菌培养及药敏试验结果研究

Analysis of pus bacteria culture and drug sensitivity test in children with acute appendicitis

目的：分析小儿急性阑尾炎主要致病细菌及药敏情况，为临床合理应用抗生素提供依据。方法：自2005年8月-2007年7月，在我院行阑尾切除术患儿，术中采集腹腔渗液标本共84例，进行细菌培养及药敏试验。回顾分析培养阳性的65株需氧菌及药敏结果。结果：小儿急性阑尾炎主要致病细菌仍以大肠埃希菌为主，其药物敏感率由高到低依次为亚胺培南、哌拉西林／他唑巴坦、阿米卡星、头孢他啶、头孢匹肟、头孢曲松、头孢唑啉、庆大霉素、氨苄西林／舒巴坦。氨苄西林全部耐药。结论：大肠埃希菌仍为目前小儿急性阑尾炎主要致病细菌，对临床常用的抗生素有较高的耐药性。脓液细菌培养对术前合理用药及术后抗生索的选用有指导意义。

Objective To analyze the major pathogenic bacteria and drug sensitivity in children with acute appendicitis, and to offer the foundation of clinically selection of reasonable antibiotics. Method From August 2005 to July 2007, the results of bacteria culture and drug sensitivity from 65 positive specimens of 84 abdominal cavity pus specimens were collected in children underwent appendectomy. Results The major pathogenic bacteria was Escherlchia coli in childhood acute appendicitis ,and the drug sensitivity rates from high to low were imipenem, compound piperacillin, amikaein, ceftazidime, cefepime, ceftriaxone, cefazolin, gentamyein, ampicillin - sulbactam. Ampicillin was absolutely resistant. Conclusion Eseherichia coli is the major pathogenic bacteria in childhood acute appendicitis as before, and has high resistance rates to routine antibiotics. Pus bacteria culture may offer guidance in the antibiotic treatment in children with acute appendicltis.