细菌L型感染现状与耐药分析

The Analysis of 427 Strains of Bacteria L form in Nosocomial Infection and Their Drug Resistance

目的：提高感染性标本中细菌培养阳性率及促进合理用药。方法：采取了１８７０例住院患者的血、尿、脑脊液、胸腹水、胆汁等标本，进行常规与高渗同步培养，以及药敏试验。结果：高渗同步培养分离出Ｌ型细菌４２７株，而普通培养均为阴性，阳性率提高了２２８％，分离菌种达１１种；金黄色葡萄球菌在各类标本中感染率占首位，１９４４％；大肠杆菌占第２位，１６４％；凝固酶阴性葡萄球菌、Ｄ群肠球菌、酵母菌占第３位，分别为１１０％、１０７７％、１０３％；其它各种菌属均占有一定比例。分离出的细菌Ｌ型均对青霉素、头孢类抗生素高度耐药，对红霉素、氯霉素、庆大霉素、林可霉素呈低度耐药。结论：采取同步培养可提高细菌检测阳性率，为临床感染性疾病诊断和抗生素的合理使用提供了重要依据。

Objective:To increase the positive rate of bacteria in nosocomial infection and use antibiotics reasonably.Methods:The results of blood,urine,cerebrospinal fluid,pleural effusion,ascites and bile specimens of 1 870 inpatients from January 1995 to December 1997 with routine culture and hyperosmolarity culture were analyzed in tandem.Results 427 strains of bacteria L form were separated from the specimens with line culture and hyperosmolarity culture.The positive rate was increased by 22.8%.11 sorts of bacteria were separated.The first was S anaveus.The Second was E coil.The third was coagulase negative staphylococcus,Enterococcus D group and yeast.They were 19.44%,16.4%,11.0%,10.77%,10.3% respectively.Drug sensitivity results showed that they were highly resistant to penicillin and lephalosporins ,and lowly resistant to erythromycin ,chlo ramphenical, gentamicin and lincomycin .Conclusion:The adoption of step for step culture could not only increase the positive rate,but also formed an inportant basis for the diagnosis of infective diseases and rational administration of antibiotics.