重症急性胰腺炎患者术后感染病原菌分布与耐药性分析

Distribution and drug resistance of pathogenic bacteria in severe acute pancreatitis complicated with postoperative infections

目的观察和分析重症急性胰腺炎(SAP)患者术后感染病原菌分布及耐药性,为制定临床治疗方案提供客观参考依据。方法选取2012年1月-2013年12月100例行引流手术且术后胰腺感染SAP患者作为研究对象,对其腹腔引流物病原菌分布及耐药性进行检测,数据采用WHONET 5.4软件进行统计分析。结果共分离出321株病原菌,以革兰阴性菌为主,共251株占78.2%;在革兰阴性菌中,大肠埃希菌和肺炎克雷伯菌中分别检出22株和13株产ESBLs菌,产ESBLs菌的总检出率为10.9%;鲍氏不动杆菌和铜绿假单胞菌对多黏菌素B耐药率低,均为0;在革兰阳性菌中,屎肠球菌、金黄色葡萄球菌对替考拉宁、万古霉素、利奈唑胺耐药率低,均为0。结论 SAP术后胰腺感染的病原菌分布和耐药性具有一定的特征,临床医师应尽量选用敏感性抗菌药物进行治疗,以达到提高治疗效果、改善患者预后。

OBJECTIVE To observe and analyze the distribution and drug resistance of pathogenic bacteria in severe acute pancreatitis（SAP）complicated with postoperative pancreatic infection,so as to provide objective evidence for clinical treatment.METHODS A total of 100 cases of patients with SAP treated with surgical drainage and complicated with postoperative pancreatic infection from Jan.of 2012 to Dec.of 2013 were selected as the research objects.The distribution and drug resistance of pathogenic bacteria in the abdominal cavity drainage of the patients were detected and compared.Dat were analyzed by WHONET 5.4.RESULTS A total of 321 strains of pathogens were isolated,mainly gram negative bacteria and the distribution rates were 78.2%.22 strains and 13 strains producing extended spectrum beta-lactamases（ESBLs）in Escherichia coli and Klebsiella pneumoniae were detected.The overall detection rate of ESBLs producing strains was 10.9%.Acinetobacter baumannii and Pseudomonas aeruginosa had low resistant rates to polymyxin B,both 0.In gram positive bacteria,Enterococcus faecium and Staphylococcus aureus had low resistant rates to teicoplanin,vancomycin and linezolid,all in 0.CONCLUSION The distribution and the drug resistance of pathogenic bacteria in postoperative pancreatic infection of patients with SAP has some characteristics.The clinicians should try to choose the sensitivity antimicrobial drugs for treatment in order to improve the therapeutic effects and the prognosis of patients.