产后盆腔炎患者病原菌分布及耐药性研究

Distribution and drug resistance of pathogens in patients with postpartum pelvic inflammatory disease

目的分析产后盆腔炎(PID)患者的病原菌分布特点和耐药情况的研究,探讨产后患者盆腔炎感染特征。方法回顾性选取在2015年3月-2016年7月期间于医院妇产科明确诊断为盆腔炎的112例患者为研究对象,采集宫内分泌物进行菌株培养分离,并采用MicroScan walkAway-96全自动微生物菌种鉴定仪进行细菌鉴定和药敏试验,统计分析PID患者的病原菌鉴定结果及耐药性。结果 112例感染患者送检的分泌物样本中共检出病原菌97株,检出率为86.61%,其中革兰阴性菌68株占70.10%,革兰阳性菌22株占22.68%,真菌7株占7.22%;大肠埃希菌对诺氟沙星、庆大霉素和头孢替唑钠的耐药率较高,均>50%,对头孢克肟和美罗培南的耐药率较低,均<5%;肺炎克雷伯菌对诺氟沙星、庆大霉素和左氧氟沙星耐药率较高,均≥60%;金黄色葡萄球菌对青霉素、氨苄西林和克林霉素的耐药率较高,均>70%。结论 PID是产后女性易感染疾病,其主要致病菌为革兰阴性菌,而美罗培南、头孢克肟及氟喹诺酮类抗菌药物对其有明确地抑菌作用,在临床治疗产后盆腔炎患者应根据细菌培养结果,能够合理使用抗菌药物,有效控制感染发展和降低耐药情况的产生。

OBJECTIVE To investigate the distribution characteristics and drug resistance of pathogenic bacteria in patients with postpartum pelvic inflammatory disease（PID）,and to explore the characteristics of pelvic inflammatory infection in postpartum patients.METHODS A total of 112 postpartum women who were diagnosed as pelvic inflammatory disease in our hospital from Mar.2015 to Jul.2016 were retrospectively chosen.The intrauterine secretions were isolated and cultured.MicroScan walkAway-96 was used to identify bacteria and take susceptibility testing,and the results of identification of pathogens in patients with PID and drug resistance were analyzed.RESULTS Among the 112 samples,97 strains of pathogens were detected,with the detection rate of 86.61%,including 68 strains of gram-negative bacteria accounting for 70.10%,22 strains of gram-positive bacteria accounting for 22.68%,and 7 strains of fungi accounting for 7.22%.The resistant rates of Escherichia coli to norfloxacin,gentamicin and ceftezole sodium were high,which were all more than 50%,and to cefixime and meropenem was low,which were all below 5%.The resistant rates of Klebsiella pneumoniae to norfloxacin,gentamicin and levofloxacin were high,which were greater than or equal to 60%.The resistant rates of Staphylococcus aureus to penicillin,ampicillin and clindamycin were high,which were all higher than 70%.CONCLUSIONPID is a susceptible disease for postpartum women,the main pathogens are gram-negative bacteria,and meropenem,cefixime and fluoroquinolone antibacterial drugs have a clear antibacterial effect.In the clinical treatment of postpartum pelvic inflammatory disease,patients should be based on bacterial culture results to take the rational use of antimicrobial drugs,effectively control infections and reduce the development of drug resistance.