肛周脓肿致病菌的分布、变迁及药敏变化

Distribution, Change and Drug-sensitivity Changes of Perianal Abscess Pathogenic Bacteria

目的探讨肛周脓肿致病菌的分布、变迁及药敏变化。方法采用回顾性方法分析,选取该院自2015年1月—2017年12月收治的189例肛周脓肿患者的临床资料,进行细菌培养、鉴定及药敏试验。结果 189例中无细菌生长32例,占16.93%(32/189);有细菌生长157例,占83.07%(157/189)。革兰氏阳性菌5例,占3.18%(5/157),革兰氏阴性菌152例,占96.82%(152/157)。革兰氏阴性菌152例中大肠埃希菌111例(73.02%);其次为肺炎克雷伯菌25例(16.45%)。革兰氏阴性菌耐药试验中氨苄西林耐药率78.20%居于首位;其次为头孢唑林耐药率72.37%、头孢噻吩耐药率47.37%、复方新诺明耐药率43.16%。革兰氏阳性菌药敏试验中,青霉素耐药率100.00%,其次为苯唑西林80.00%、庆大霉素60.00%。2015、2016、2017年的肛周脓肿检出情况经对比分析,差异无统计学意义(P>0.05)。结论大肠埃希菌是肛周脓肿主要致病菌,应根据药敏试验合理选择治疗药物,有效治疗肛周脓肿及控制耐药菌的产生及其播散。

Objective To study the distribution, change and drug-sensitivity changes of Perianal abscess pathogenic bacteria. Methods The clinical data of 189 cases of patients with perianal abscess in our hospital from January 2015 to December 2017 were retrospectively analyzed for bacterial culture, identification and drug sensitivity test. Results There were 32 cases without bacterial growth of 189 cases, accounting for 16.93%（ 32/189）; 157 cases with bacterial growth, accounting for 83.07%（ 157/189）, 5 cases with gram-positive bacteria, accounting for 3.18%（ 5/157）, and 152 cases with gram-negative bacterium, accounting for 96.82%（152/157）, and there were 111 cases with E.coli（ 73.02%）,and the second was 25 cases with klebsiella pneumonia（16.45%）, and the drug tolerance rate of ampicillin in the gramnegative bacteria drug-tolerance test was 78.20%, in the first place, followed by cephazolin 72.37%, cephalothin47.37%, compound sulfamethoxazole 43.16%. In the gram-positive bacterium drug sensitivity test, the drug resistance rate of penicillin was 100.00%, followed by oxacillin 80.00% and gentamycin 60.00%. The difference in the test of perianal abscess among 2015, 2016 and 2017 was not statistically significant（P0.05）. Conclusion The E.coli is the major pathogenic bacteria of perianal abscess, and we should rationally select the treatment drugs according to the drug sensitivity test thus effectively treating the perianal abscess and controlling the occurrence and spread of drug-fast bacteria.