2013年-2015年腹腔感染标本病原菌及耐药性分析

Analysis of pathogenic bacteria and drug resistance in intro-abdominal infection during 2013-2015

目的分析本院腹腔感染患者病原菌分布及耐药性情况,为指导临床合理应用抗菌药物提供参考。方法回顾性分析2013年-2015年来院就诊患者的腹腔标本病原菌的分布和耐药性。结果 298例患者有50.3%来自外科,共分离出病原菌408株,其中革兰阳性菌150株(36.8%),革兰阴性菌224株(54.9%),真菌34株(8.3%)。在所有病原菌中排名前6位的分别是大肠埃希菌(20.6%)、屎肠球菌(10.0%)、肺炎克雷伯菌(9.6%)、鲍曼不动杆菌(7.8%)、表皮葡萄球菌(6.1%)、铜绿假单胞菌(5.1%)。主要病原菌对临床常用药物高度耐药。分离出耐碳青霉烯类的肠杆菌科细菌6株。鲍曼不动杆菌、铜绿假单胞菌的多重耐药菌比例分别为68.8%、33.3%。结论本院腹腔感染细菌以阴性杆菌为主,耐药形势严峻,及时准确分析其特点,为临床提供治疗依据。

Objective To investigate the distributions and antimicrobial resistances of the bacteria in patients with intro-abdominal infection in our hospital,in order to provide guidance for clinical rational use of antibiotics. Methods The distributions and antimicrobial resistances of the bacteria in patients with intro-abdominal infection admitted from 2013 to 2015 were analyzed retrospectively. Results A total of 408 clinical pathogen isolates were collected from 298 patients,50. 3% of whom were from surgery department,of which gram-positive cocci,gram-negative organiams,and Fungi accounted for 36. 8%（ 150strains）,54. 9%（ 224 strains） and 8. 3%（ 34 strains）,respectively. The top 6 prevalent isolated pathogens were Escherichia coli（ 20. 6%）,Enterococcus faecium（ 10. 0%）,Klebsiella pneumonia（ 9. 6%）,Acinetobacter baumannii（ 7. 8%）,Staphylococcus epidermidis（ 6. 1%）,Pseudomonas aeruginosa（ 5. 1%）. The main pathogenic bacteria were highly resistant to common drugs. 6 strains of Carbapenem-resisitant Enterobacteriaceae were isolated. The ratio of multiple resistant strains of Acinetobacter and Pseudomonas aeruginosa was 68. 8% and 33. 3%,respectively. Conclusion The bacteria of intro-abdominal infection is mainly negative bacilli and the resistance is severe. To analyze the characteristics timely and accurately is necessary for providing basis for clinical treatment.