肛周脓肿细菌感染的病原菌分布及耐药性

Pathogens causing bacteriological perianal abscess infections and drug resistance

目的了解肛周脓肿细菌感染的病原菌分布及对常用抗菌药物的耐药性,以便指导临床用药。方法医院2009-2011年收治82例肛周脓肿患者,对其脓液进行病原菌培养及药敏试验。结果 82例患者临床共分离病原菌143株,其中厌氧菌80株占55.9%,需氧菌63株占44.1%,革兰阴性菌125株占87.4%,革兰阳性菌18株占12.6%,检出株数居首位的为脆弱拟杆菌,检出63株占44.0%,其次为大肠埃希菌占28.0%;82例肛周脓肿患者中,单纯厌氧菌感染26例占31.7%,单纯需氧菌感染2例占2.4%,混合感染54例占65.9%;革兰阳性菌对万古霉素的敏感率最高,达100.0%,革兰阴性菌对亚胺培南的敏感率最高,达99.2%。结论肛周脓肿多为内源性细菌感染,是以革兰阴性杆菌和厌氧菌感染为主的混合性感染,治疗时应首选抗革兰阴性杆菌药物治疗。

OBJECTIVE To understand the species of pathogens causing bacterial perianal abscess infections and their drug resistance to commonly used antibiotics so as to guide clinical practice.METHODS A total of 82 patients with perianal abscess who enrolled in hospital from 2009 to 2011 were selected for pus pathogens culture and drug susceptibility testing.RESULTS Totally 143 strains of pathogens were isolated from 82 patients,including 80（55.9%） strains of anaerobic bacteria,63（44.1%） strains of aerobic bacteria,125（87.4%） strains of gram-negative bacteria,and 18（12.6%） strains of gram-positive;B.fragilis（63 strains） were the top pathogens isolated,accounting for 44.0%,followed by Escherichia coli,accounting for 28.0%;of 82 patients with perianal abscess,there were 26（31.7%） cases with simple anaerobic infections,2（2.4%） cases with simple aerobic infections,and 54（65.9%） cases with mixed infections;the drug susceptibility testing showed that the susceptibility rate of gram-positive bacteria to vancomycin was the highest,reaching 100.0%,and the susceptibility rate of gram-negative bacteria to imipenem was the highest,reaching 99.2%.CONCLUSION Perianal abscess are mostly endogenous bacterial infections which mainly caused by gram-negative bacilli and anaerobic bacteria,so the antibiotics for the treatment of gram-negative bacilli infection should be primarily selected.