721例浆膜腔积液培养结果及菌株耐药性分析

Pathogens and Their Resistance to Antibiotics from 721 Serous Effusion Specimens

目的调查患者浆膜腔积液培养阳性结果及耐药状况,以期对浆膜腔感染病原菌的分析和对临床使用抗菌药物有所帮助。方法2006年1月-2008年2月对721例浆膜腔积液患者按常规培养方法进行细菌培养、鉴定及药敏测试。结果721例浆膜腔积液标本培养阳性49株,阳性率6.80%,其中革兰阳性菌15株(30.61%),革兰阴性菌28株(57.14%),真菌6株(12.25%);排前3位的病原菌分别为:肠杆菌科16株(32.65%),肠球菌属9株(18.37%),铜绿假单胞菌6株(12.25%);对肠球菌属的敏感率为:万古霉素和利奈唑烷(100.00%)、呋喃妥因和四环素(66.67%);对葡萄球菌属的敏感率为:万古霉素、利奈唑烷和呋喃妥因(100.00%)、四环素和利福平(75.00%);对革兰阴性菌的平均敏感率为:哌拉西林/他唑巴坦(67.86%)、亚胺培南(64.29%)、妥布霉素(60.71%)、庆大霉素(53.57%)、左氧氟沙星(46.43%)。结论浆膜腔积液标本培养阳性病原菌以革兰阴性菌多见,尤其是肠杆菌科细菌,调查结果为浆膜腔感染的预防和经验性抗菌药物治疗提供可靠的数据资料。

OBJECTIVE To analyze the pathogenic results and drug resistance of bacteria isolated from serous effusion specimens from Jan 2006 to Feb 2008 so as to provide evidence for clinical pathogenic analysis and selection of antibiotic. METHODS The bacteria identification and the antimicrobial susceptibility were assayed by routine methods. RESULTS The positive rate of pathogens was 6.80% from 721 serous effusion specimens. There were 49 strains of pathogens which included 15 of Gram-positive bacteria and 28 of Gram-negative bacteria and 6 fungi strains. The most frequently isolated pathogens were Enterobacteriaceae （32. 65%） followed by Enterococcus （18.37 %）, and Pseudomonas aeruginosa （12.25 %）. The most active compounds against Enterococcus were vanconmycin and linezolid （100. 00%）, nitrofurantoin and tetracycline（66. 67%）; the most active compounds against Staphylococcus were vancomycin, iinezolid and nitrofurantoin （100.00%）, tetracycline and rifampin（75. 00%）; The most active compounds against Gram-negative bacilli were piperacillin/tazobactam （67.86 %）, imipenem （ 64.29% ）, tobramycin （ 60. 71%）, gentamicin （ 53. 57%） and levofloxacin （ 46. 43 %）. CONCLUSIONS The prevailing pathogens in serous effusion are Gram-negative bacilli, especially Enterobacteriaceae. Data collected in present study provide a valuable information for prophylactic and empirical antibiotic use for serous infection.