肝硬化合并自发性细菌性腹膜炎的病原菌耐药性调查

Antimicrobial resistance of pathogens in liver cirrhosis patients associated with spontaneous bacterial peritonitis

目的探讨肝硬化合并自发性细菌性腹膜炎(SBP)的病原菌分布及耐药现状,为临床医师控制感染提供试验依据。方法回顾性调查118例SBP的病历资料,病原菌培养鉴定按照《全国临床检验操作规程》进行;药敏试验采用K-B法,结果按照CLSI规则评价。结果肝硬化合并SBP的129株病原菌中,大肠埃希菌居第1位,占51.9%;肺炎克雷伯菌居第2位,占28.7%;病原菌对常用抗菌药物产生了不同程度的耐药性。结论感染科必须预防肝硬化患者SBP的发生,以免加重病情恶化而导致预后不良。

OBJECTIVE To investigate pathogenic distribution and antimicrobial resistance of pathogens in liver cirrhosis patients associated with spontaneous bacterial peritonitis（SBP） and provide the experimental evidence for clinical controlling of infection.METHODS A total of 118 cases of SBP were reviewed retrospectively.Referring to National guide to clinical laboratory Operation procedures,pathogenic bacteria were cultured and identified.The antibiotical susceptibility testings were performed by K-B method.The susceptibility testings results were assessed according to CLSI breakpoints.RESULTS Among 129 isolates,the top two of isolating rate were Escherichia coli（51.9%） and Klebsiella pneumoniae（28.7%）,respectively.The varying antimicrobial resistance existed in the other commonly used antibiotics.CONCLUSIONS The clinician in Department of Infection should prevent the occurrence of SBP associating with liver cirrhosis in order to avoid unfavourable prognosis caused by worse condition.