哺乳期与非哺乳期乳腺脓肿病原菌分布及耐药性比较

Distribution and resistance comparison of the pathogen of breast abscess between lactation and non lactation

目的分析哺乳期与非哺乳期乳腺脓肿病原菌分布及耐药性,指导临床用药。方法回顾性分析2013年1月-2015年12月湖州市妇幼保健院送检220例乳腺脓肿脓液标本。结果哺乳期乳腺脓肿分离92株致病菌,其中革兰阳性菌89株,革兰阴性菌3株;非哺乳期乳腺脓肿分离77株致病菌,其中革兰阳性菌58株,革兰阴性菌18株,真菌1株。哺乳期分离金黄色葡萄球菌对青霉素耐药率为97.22%,红霉素耐药率为66.67%,克林霉素耐药率为65.28%;非哺乳期分离金黄色葡萄球菌对青霉素耐药率为100.00%,红霉素耐药率为78.57%,克林霉素耐药率为78.57%。结论乳腺脓肿细菌感染绝大多数为革兰阳性球菌,哺乳期以金黄色葡萄球菌最为常见,非哺乳期以金黄色葡萄球菌和凝固酶阴性葡萄球菌为主,其对青霉素、红霉素、克林霉素耐药率高,不适合作为常规治疗药物。临床治疗应以细菌培养结果为指导,合理使用,避免乱用和滥用抗菌药物。

Objective To study the distribution and resistance of the pathogen of breast abscess between lactation and non - lactation, so as to guide clinical drug - use. Methods To retrospectively analyze the 220 clinical abscess samples from Huzhou Maternity and Child Care Hospital during Jan. 2013 - Dec. 2015. Results The pathogen were isolated from 92 sampled with 89 G^＋ and 3 G^- in lactation; the pathogen were isolated from 77 sampled with 58 G^＋ , 18 G^- and 1 Fungus in non -lactation. The resistance rate of Staphylococcus aureus to penicillin was 97.22% , 66.67% to erythromycin, 65.28% to clindamyein in lactation; the resistance rate of it to penicillin was 100.00% , 78.57% to erythromycin, 78.57% to clindamycin in non lacta- tion. Conclusion G ＋ pathogen infection was predominant in breast abscess, Staphylococcus aureus mostly were isolated in lactation, and Staphylococcus aureus or coagulase negative staphylococcus were detected in non -lactation. These pathogen have a high resistance rate to penicillin, erythromycin, and clindamycin, which were not suitable for clinical therapy. The bacterial culture should be considered as guideline for clinical therapy to use antibiotics properly and to avoid antibiotics abuse.