肝硬化并发自发性腹膜炎的病原菌及耐药状况

Pathogen distribution and drug resistance in patients with liver cirrhosis and spontaneous bacterial peritonitis

目的探讨肝硬化合并自发性细菌性腹膜炎（SBP）的病原菌及耐药状况。方法分析108例肝硬化并发SBP住院的患者其腹水病原菌构成及耐药率。结果腹水中病原菌以大肠埃希菌的比例最高，占39．6％，其次是肺炎克雷伯菌、阴沟肠杆菌、铜绿假单胞菌、表皮葡萄球菌，其中大肠埃希菌和肺炎克雷伯菌产超广谱肛内酰胺酶（ESBLs）比例分别占27．3％和23．0％。结论肝硬化并发SBP患者应及时行腹水培养，并结合临床症状及药敏报告合理应用抗生素。

Objective To evaluate the distribution and drug resistance of pathogens in patients of liver cirrhosis combined with spontaneous bacterial peritontis（SBP）. Methods Ascitic fluids of 108 cases of hospitalized patients with liver cirrhosis and SBP in our hospital between Jan 2002 and Dec 2037 were cultured. Of the 111 isolates, pathogens were identified and the drug resistances were analyzed. Results The ratio of Escherichia coli in the ascitic fluids was the highest among pathagens（39.6 % ）, the next were Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa and Staphylococcus epidermidis. Extended-spectrum β-lactamases in Escherichia coli and Klebsiella pneumoniae were 27.3% and 23.0% respectively. Conclusions Patients with liver cirrhosis and SBP should make the ascites culture in time. The antibiotics should be reasonably chosen according to the sensitive test of the pathogens.