肝硬化患者合并肺部感染痰培养中微生物谱及抗生素耐药分析

Analysis of microbial spectrum and antibiotic resistance in sputum culture of patients with liver cirrhosis complicated with pulmonary infection

目的调查肝硬化患者合并肺部感染痰培养中微生物谱及抗生素耐药。方法2016年10月-2018年10月在本院发生肺部感染的426例肝硬化患者。收集患者的相关信息,包括肺部感染数据、细菌分布、药敏试验结果和经验性抗生素治疗方案。结果从痰标本中分离出426种培养物。其中,59.6%被证实为革兰阴性,40.4%为革兰阳性。革兰阴性菌主要包括大肠杆菌、肺炎克雷伯菌、嗜水气单胞菌、阴沟肠杆菌等。革兰阳性生物包括凝固酶阴性葡萄球菌、链球菌属、金黄色葡萄球菌和肠球菌属。药物敏感性试验结果显示,分离的革兰阴性菌株对阿米卡星、头孢哌酮/舒巴坦、美罗培南、亚胺培南和哌拉西林/他唑巴坦高度敏感;革兰阳性菌对万古霉素和替考拉宁高度敏感。结论在肝硬化患者中,革兰阴性菌是引起肺部感染的主要病原菌。

Objective To investigate the microbial spectrum and antibiotic resistance of sputum culture isolated from liver cirrhosis patients with pulmonary infection.Methods This retrospective study included 426 patients with cirrhosis who developed pulmonary infection in our hospital from October 2016 to October 2018.The collected information included pulmonary infection data,bacterial distribution,drug sensitivity test results,and empirical antibiotic regimens.Results In total,426 cultures were isolated from the sputum specimens.59.6%were confirmed to be Gram-negative,while 40.4%were Gram-positive.The Gram-negative bacteria mainly included Escherichia coli,Klebsiella pneumoniae,Aeromomas species,Enterobacter cloacae,and others.Gram-positive organisms included Coagulase-negative staphylococci,Streptococcus spp.,Staphylococcus aureus,and Enterococcus spp.Drug sensitivity analysis of Gram-negative bacterial showed that these strains were highly sensitive to amikacin,cefoperazone/sulbactam,meropenem,imipenem,and piperacillin/tazobactam,and Gram-positive bacteria were highly sensitive to vancomycin and teicoplanin.Conclusion Gram-negative bacteria are the major pathogens responsible for pulmonary infection in liver cirrhosis patients.