细菌性腹膜炎病原菌分布及其耐药性分析

Analysis of the distribution of pathogens and antibiotic resistance in patients with bacterial peritonitis

目的分析细菌性腹膜炎病原菌分布及耐药状况。方法用phoenixTM100细菌鉴定及药敏分析仪对113株腹膜炎患者腹水中分离的病原菌进行菌株鉴定和药敏试验。结果在分离的113株细菌中,革兰阴性杆菌、革兰阳性球菌及真菌分别占56.6%、39.9%和3.5%;革兰阴性菌中以大肠埃希菌占绝对优势(23.0%),革兰阳性菌中以凝固酶阴性葡萄球菌占绝对优势(15.9%)。产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌分别占该种细菌的53.8%和36.4%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占凝固酶阴性葡萄球菌的88.9%,耐甲氧西林金黄色葡萄球菌(MRSA)占金黄色葡萄球菌的57.1%。药敏试验表明细菌性腹膜炎的病原菌表现为较高的耐药率及多重耐药性。结论细菌性腹膜炎的病原菌耐药性严重,及时监测病原菌的变迁和耐药发展趋势以指导临床用药至关重要。

Objective To analysis of the distribution of pathogens and antibiotic resistance in pantients with bacteri- al peritonitis. Methods 113 bacterial strains isolated from ascites of patients with bacterial peritonitis were identified and performed antimicrobial susceptibility by phoenixTUl00. Results Among the 113 bacterial strains,the percentage of Gram-negative bacill,Gram-positive cocci and fungi were 56. 6%, 39. 9% and 3. 5% respectively. The most common bacteria were Escherichia coil（23.0%） and coagulase-negative staphylococcus （15.9 % ）. 53.8% of Escherichia coil and 36.4% of klebsiella pneumoniae produced extended-spectrum β-lactamases; 88. 9 % of coagulase-negative staphylococ- cus and 57.1% of staphylococcus aureus were methicillin-resistant. There were the high antibiotic resistance rates and multi-resistant in pathogens of patients with bacterial peritonitis. Conclusion The antibiotic resistance of pathogens in patients with bacterial peritonitis was serious. We should monitor timely changes and development trend of antibiotic resistance of bacteria in order to guide clinical medication.