427株细菌L型医院感染与耐药分析

Analysis on 427 strains of bacteria L-form in nosocomial infection and the drug resistance

目的 为提高医院感染细菌培养阳性率及抗菌药物的有效使用。方法 对我院 1995年 1月～ 1997年 12月从 1870例住院患者采取血、尿、脑脊液、胸腹水、胆汁等标本进行了常规与高渗同步培养的结果进行了对照分析。结果 分离出 L型细菌 4 2 7株 ,而普通培养均为阴性 ,阳性率提高了 2 2 .8% ,分离菌种达 11种之多 ;以金黄色葡萄球菌在各类标本中感染率占首位 ,19.4 4% ;大肠埃希菌占第 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%、10 .77%、10 .3 % ;其它各菌属均占有一定比例。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 enhance the positive culture rate of bacteria in nosoconial infection and to guide the proper use of antibiotics.METHODS The routine and hyperosmotic culture results performed on the samples of blood ,urine,cerebrospinal fluid,pleural effusion,ascites and bile from 1870 inpatients during Jan 1995 to Dec 1997 were analyzed in tandem.RESULTS 427 strains of bacteria L form were separated out with the synchronous culture method from the negative specimens on routine culture, the positive rate was increased by 22.8%.The posifive strains were belonged to 11 kinds of bacteria, in which the first was S.aureus,the second was E.coil,and then coagulase negative Staphylococcus,Enterococcus D group and yeast. Their positive rates were 19.44%,16.4%,11%,10.77%and 10.3% respectively.The drug sensitivity results showed that they were highly resistant to penicillin and cephalosporins,lower to erythromycin,chloramphenical, gentamicin and lincomycin. CONCLUSIONS The method step by step culture may not only increase the positive culture rate,but also provide very important clew in the diagnosis of doubtful cases and enhance the rational administration of antibiotics.