61例抗生素相关性腹泻患者失调菌群耐药性分析

Analysis on the drug resistance of dysbacteriosis of patients with antibiotic associated diarrhea in 61 cases

目的了解抗生素的使用对患者肠道菌群的影响,以及失调菌群的耐药性。方法采用粪便细菌培养进行分析,同时对相应患者通过查病历了解其抗生素使用情况。结果 2010年5月至2011年12月共发现相关患者61例,主要发病人群为老年人、婴幼儿以及重症患者。61例相关腹泻患者大便培养,培养出念珠菌24例,肠球菌22例,奇异变形杆菌8例,葡萄球菌5例,铜绿假单胞菌2例。其中白色念珠菌对各种抗真菌药保持较好的敏感性,而非白色念珠菌耐药性明显高于白色念珠菌。粪肠球菌和类粪肠球菌对利奈唑胺、呋喃妥因和万古霉素耐药性较低,通过比较可知粪肠球菌和类粪肠球菌对呋喃妥因、利奈唑胺、利福平、青霉素G、万古霉素的耐药率比较差异无统计学意义(P>0.05),而两者对链霉素2000、莫昔沙星、庆大霉素、左旋氧氟沙星耐药率比较差异有统计学意义(P<0.05)。结论对特殊患者进行粪便培养检查是实验室诊断抗生素相关性腹泻较好的方法,可以给临床提供实验依据,防止抗生素的滥用。

Objective To understand the influence of antibiotics on intestinal flora of patients,and the durg resistance of dysbacteriosis.Methods We analyzed the fecal bacterial culture,and understood the situation of using antibiotic by investing the case history.Results During May 2010 to Dec 2011,61 patients were found with the antibiotic associated diarrhea,especially in the elder,infants and critical patients.After the stool culture of the 61 samples,there were 24 cases of candida,22 cases of enterococcus,8 cases of proteus mirabilis,5 cases of ureus,2 cases of pseudomonas aeruginosa were found.Candida albicans had a high sensitivity to various antifungal agents,but the drug resistances of other albicans were significantly higher than the candida albicans.Enterococcus faecalis and class of enterococcus faecalis had low drug resistance to linezolid,nitrofurantoin,and vancomycin.By comparing the data,we found that the drug resisitance of Enterococcus faecalis and class of Enterococcus faecalis in nitrofurantoin,linezolid,rifampicin,penicillin G,vancomycin had no significant difference（P〈0.05）,and the drug-resistance in streptomycin,Tamoxifen,gentamicin,levofloxacin had significant difference（P〈0.05）.Conclusion The stool culture test was a better way to diagnose antibiotic associated diarrhea,it could provide experimental basis for clinical and prevent the abuse of antibiotics.