肛瘘术后发生感染的病原菌分布及耐药性分析

Distribution of Infected Pathogenic Bacterium after Anal Fistula Surgery,and Their Drug-resistance Analysis

为分析肛瘘患者术后发生感染的病原菌分布及耐药性,采集110例术后发生感染患者的分泌物进行细菌培养和药敏试验。结果显示,110例患者中共分离出167株病原菌,革兰阴性菌137株(82.04%),其中大肠埃希菌82株(49.10%),肺炎克雷伯菌28株(16.77%);革兰阳性菌30株(17.96%)。大肠埃希菌对大多数常用抗菌药物的耐药性均较高;肺炎克雷伯菌对头孢唑林和左氧氟沙星耐药率最高,其次为复方磺胺甲恶唑,对其他抗菌药物耐药率较低;奇异变形杆菌对亚胺培南、左氧氟沙星耐药率最高,其次为氨苄西林、庆大霉素和环丙沙星。葡萄球菌属对大多数抗菌药物耐药率均较高,仅对哌拉西林和万古霉素无耐药性;链球菌属对复方磺胺甲恶唑耐药率最高,其次为氨苄西林,对阿莫西林、庆大霉素和万古霉素无耐药性。结果表明,肛瘘患者术后感染的病原菌主要为大肠埃希菌、肺炎克雷伯菌、葡萄球菌,耐药性各不相同。临床应根据细菌培养和药敏试验结果将病原菌分类,为患者选择敏感性高和效果好的广谱抗菌药,以降低术后感染率,提高疗效。

This study was to analyse distribution of infected pathogenic bacterium(PB)after surgery for anal fistula(AF),and PB’s drug-resistance,collected the secretion of 110 cases with postoperatively infected PB to culture it and perform drug-sensitivity test on it.As results,in above 110 cases’ secretion 167 strains PB were isolated:G-,137(82.04%)included Ec.oli 82(49.10%),Klebsiella pneumoniae 28(16.77%);G+,30(17.96%).Ec.oli had higher drug-resistence to most common antimicrobial drugs;Klebsiella pneumoniae had the highest drug-resistance rate to cefazolin and levofloxacin,next to compound sulfamethoxazole,more lower rate to other antimicrobial drugs;Protens mirabilis had the highest rate to imipenem,levofloxacin,nest to ampicillin,gentamycine and ciprofloxacin;Staphylococcus had higher rate to most antimicrobial drugs,only not to piperacillin and vancomycin;Streptococcaceae had the highest rate to compound sulfamethoxazole,next to ampicillin,but not to amoxicillin,gentamycine and vancomycin.Results show that after anal fistula surgery the infected PB mainly are Ec.oli,Klebsiella pneumoniae,staphylococcus which have different drug-sensitivity test results,so as to choose broad-spectrum antibiotics with high sensitivity and good efficacy,to reduce postoperative infection rate and to enhance curative effect.