肛周脓肿和肛瘘脓液细菌分布规律及药敏结果分析

Analysis on Distribution and Drug-sensitivity Test Results of the Bacterium in Pus from Perianal Abscess and Anal Fistula Patients

为探讨肛周脓肿和肛瘘患者脓液细菌分布规律及药敏结果,为临床医师合理使用抗生素提供依据。回顾性分析本院151例肛周脓肿和肛瘘患者脓液细菌培养和药敏结果。结果显示,151份脓液标本中,革兰阴性菌共计86株,占81.90%;革兰阳性菌共计19株,占18.10%。革兰阴性菌敏感抗生素前五位为阿米卡星、美罗培南、哌拉西林/他唑巴坦、厄他培南、亚胺培南,药物敏感度在100%~96.51%;耐药率较高的抗生素是头孢他啶/克拉维酸钾、头孢噻肟/克拉维酸钾、呋喃妥因、氨苄西林、氨苄西林/舒巴坦,耐药率高达97.67%~61.63%。革兰阳性菌敏感抗生素前五位为达托霉素、利奈唑胺、万古霉素、喹奴普丁/达福普汀、利福平,药物敏感度在100%~78.95%;耐药率较高的抗生素是氨苄西林/舒巴坦、头孢曲松、苯唑西林、阿莫西林/克拉维酸钾、红霉素,耐药率高达89.47%~84.21%。结果表明,肛周脓肿和肛瘘病原菌以革兰阴性菌为主,其中大肠埃希氏菌占比最高。

In order to investigate the distribution regulation and drug-sensitivity test results of the bacterium of pus of perianal abscess(PA)and anal fistula(AF)patients,so providing the basis for clinically rational use of antibiotics,authors retrospectively analyzed 151 PA and AF patients pus with bacterium culture and their drug-sensitivity results.As results,in 151 pieces of specimens,G^- totaled 86 strains(accounted for 81.90%),G^+ totaled 19 strains(accounted for 18.10%);For G^- bacterium,the first five sensitive antibiotics were following order as amikacin,neropenem,piperacillin/tazobactam,ertapenem,imipenem(drug-sensitivity,ranged 100%~96.51%),meanwhile higher drug-resistance rate antibiotics were following as ceftazidime/clavulanate potassium,cefotaxime/clavulanate potassium,nitrofurantoin,ampicillin,ampicillin/sulbactam(drug-resistance rate,ranged 97.67%~ 61.63%).For G^+ bacterium,the first five sensitive antibiotics were following order as daptomycin,linezoid,vancomycin,quinupristin/dalfopristin,rifampicin(drug-sensitivity,ranged 100%~78.95%),meanwhile higher drug-resistance rate antibiotics were ampicillin/sulbactam,ceftriaxone,oxacillin,amoxicillin/clavulanate potassium and erythromycin(drug-resistance rate,ranged 89.47%~84.21%).The results show that G-bacterium is the main pathogen in PA and AF,and Escherichia coli accounts for the highest proportion.