哺乳期与非哺乳期患者乳腺脓肿病原菌分布及耐药性分析

Distribution and drug resistance analysis of the pathogens of breast abscess between lactation and non lactation

目的对比哺乳期与非哺乳期乳腺脓肿患者的病原菌分布及耐药性。方法选取医院2013年6月-2016年3月142例哺乳期乳腺脓肿患者为哺乳期组,76例非哺乳期乳腺脓肿患者为非哺乳期组,行细菌培养、分离、鉴定及药敏试验,对比两组病原菌分布与耐药情况。结果哺乳期患者检出病原菌株167株,其中革兰阳性球菌160株占95.81%,革兰阴性杆菌7株占4.19%,非哺乳期患者检出病原菌株86株,其中革兰阳性球菌62株占72.09%,革兰阴性杆菌22株占25.58%,真菌2株占2.33%;哺乳期患者革兰阳性球菌检出率显著高于非哺乳期(P<0.01),革兰阴性杆菌及真菌检出率显著低于非哺乳期患者(P<0.05);哺乳期患者金黄色葡萄球菌检出率79.04%显著高于非哺乳期患者34.88%,差异有统计学意义(P<0.01);哺乳期患者金黄色葡萄球菌对苯唑西林、左氧氟沙星、红霉素、克林霉素、利福平的耐药性显著低于非哺乳期患者,差异有统计学意义(P<0.05)。结论哺乳期与非哺乳期乳腺脓肿患者致病菌检出率以及对某些药物的敏感性存在明显差异,应针对不同患者选择敏感抗菌药物,以提高治疗效果,避免抗菌药物滥用现象的发生。

OBJECTIVE To compare the distribution and drug resistance of the pathogens of breast abscess between lactation and non lactation.METHODS A total of 142 lactation breast abscess women in the hospital from Jun.2013 to Mar.2016 were selected as lactation group and 76 non lactation breast abscess women were selected as non lactation group, bacterial culture, isolation, identification and drug sensitivity test were carried out, and the distribution and drug resistance were compared between the two groups.RESULTS Totally 167 strains of pathogenic bacteria were detected in lactation group, including 160 strains of gram-positive bacteria（95.8%1） and 7 strains of gram-negative bacilli（4.19%）, and 86 strains of pathogenic bacteria were detected in non lactation group, including 62 strains of gram-positive bacteria（72.09%）, 22 strains of gram-negative bacteria（25.58%） and 2 strains of fungi （2.33%）.The detection rate of gram-positive bacteria in lactation group was significantly higher than that in non lactating group（P＆lt;0.01）, and the detection rates of gram-negative bacteria and fungi was significantly lower than those in non lactating group （P＆lt;0.05）.The detection rate of Staphylococcus aureus in lactating group（79.04%） was significantly higher than that in non lactating group（34.88%） （P〈0.01）.The drug resistant rates of S.aureus to oxacillin, levofloxacin, erythromycin, clindamycin and rifampicin in lactating group were significantly lower than those in non lactating group （P〈0.05）.CONCLUSION There were significant differences in the detection rate of pathogenic bacteria and the sensitivity to drugs between lactation and non lactation breast abscess patients, so we should choose sensitive antibiotics for different patients to improve the therapeutic effects and avoid the occurrence of the abuse of antibiotics.