肛管直肠周围脓肿患者脓液细菌培养及药敏定量试验

The analysis of bacterial culture and antimicrobial susceptibility test with perianal abscess

目的分析肛管直肠周围脓肿患者的菌群分布及抗生素的耐药情况。方法对280例肛管直肠周围脓肿患者的脓液行细菌培养、革兰染色及药物敏感定量试验。结果无细菌生长30例占10.71%,革兰阳性菌6例占2.14%,革兰阴性菌244例占87.14%。大肠埃希菌184例占65.71%,肺炎克雷伯菌44例占15.71%,金黄色葡萄球菌4例占1.43%,铜绿假单胞菌3例占1.07%,阴沟肠杆菌2例占0.71%,其他细菌13例占4.64%。产ESBLs株71例占25.36%(71/280),其中大肠埃希菌67例,肺炎克雷伯菌4例。药物敏感试验结果显示细菌耐药率为0.41%~83.61%。结论肛管直肠周围脓肿以大肠埃希菌为主,其次为肺炎克雷伯菌,对抗生素耐药率均较高,单独使用抗生素疗效不佳,应及时行手术治疗。

Objective To analysis the bacterial distribution and antibiotic resistance in perianal abscess. Methods Gram staining,bacterial culture and antimicrobial susceptibility test were carried out in 280 cases with perianal abscess. Results No bacterial growth（ 30 cases） accounted for 10. 71%,Gram-positive bacteria（ 6 cases） accounted for 2. 14%,Gram negative bacteria（ 244 cases） accounted for 87. 14%. 184 cases of Escherichia coli accounted for 65. 71%,klebsiella pneumoniae 44 cases accounted for 15. 71%,staphylococcus aureus 4 cases accounted for 1. 43%,pseudomonas aeruginosa 3 cases accounted for 1. 07%,2 strains of Enterobacter cloacae accounted for 0. 71%,other bacteria accounted for 4. 64% in 13 cases.71 cases of ESBLs-producing strains accounted for 25. 36%（ 71/280）,and 67 cases of Escherichia coli,klebsiella pneumonia in 4 cases. Drug susceptibility test results showed that the rate of bacterial resistance was 0. 41% ～ 83. 61%. Conclusion Escherichia coli was the main pathogenic bacteria in perianal abscess,followed by pneumonia klebsiella bacteria,had higher resistance to antibiotics. Antibiotics alone curative effect is not good,and the surgical treatment should be done timely.