喹诺酮类药物对肛肠病手术切口病原菌感染的效果观察

Curative Efficacy of Quinolone-like Drugs on Incision Infection from Pathogenic Bacterium in Coloproctological Diseases Surgery

为观察喹诺酮类药物对肛肠病手术切口病原菌感染的治疗效果。选取我院2017年4月至2019年12月我院收治的180例肛肠病手术切口病原菌感染患者,无菌采集患者手术切口处渗液或分泌物,全自动微生物鉴定系统进行菌株鉴定,K-B纸片法测定受试菌株对萘啶酸、诺氟沙星、左氧氟沙星、环丙沙星和加替沙星敏感性。采用微量稀释法测定大肠埃希菌对萘啶酸、诺氟沙星、左氧氟沙星、环丙沙星和加替沙星敏感性。结果显示,180份标本中共有31份标本病原菌培养为阳性,阳性率17.22%。分离出31株病原菌中革兰阴性菌27株,革兰阳性菌3株,真菌1株。革兰阴性菌中大肠埃希菌20株,变形菌属3株,克雷伯菌属2株,肠杆菌属2株;革兰阳性菌中葡萄菌属2株,肠球菌属1株;真菌为假丝酵母菌1株。革兰阴性菌分离株对萘啶酸、诺氟沙星、左氧氟沙星、环丙沙星和加替沙星耐菌株为20、15、11、10和5株,耐药率分别为74.07%、55.56%、40.74%、37.04%和18.52%。革兰阳性菌分离株仅对萘啶酸和诺氟沙星,分别为2株和1株,耐药率分别为66.67%和33.33%。结果表明,大肠埃希菌是肛肠病手术切口感染的主要病原菌,且对喹诺酮类药物具有一定耐药性。

This study was to observe the curative efficacy of quinolone-like drugs on incision infected by pathogenic bacterium in surgery for coloproctological diseases,enrolled 180 cases met above condition treated in authors’hospital(2017-04-2019-12)into this study:inasepsis sampling effusion or secretion from patients’incision,determining strain by using fully antomatic microrganism identification system,and evaluating the sensitivity of the strains on nalidixic acid,norfloxacin,levofloxacin,ciproxacin and gatifloxacin by using K-B paper-piece method;as well as evaluating the sensivity of Ec.oli on above five drugs by using micro-dilution method.As results,among the 180 specimen,31(accounted for 17.22%of positivity ratio)were in positivty of pathogenic bacterium,including 27 strains of G-(20 Ec.oli,3 Protens hauser,2 Klebsiella,and 2 Enterobacter),3 of G+(2 Staphylococcus,1 Eterococcus),1 of fungus(being Candida SP.);in the isolated G-bacterium 20,15,11,10 and 5(strains)were respectively the resistant strain on halidixic acid,norfloxacin,evofloxacin,ciproxacin and gatifloxacin,their resistant rate were in order of 74.07%,55.56%,40.74%,37.04%and 18.52%;while,in the isolated G+bacterium,only 2 strains were resistant to nalidixic acid,and 1 to norfloxacin(the rate,66.67%and 33.33%).Results show that Ec.oli is main pathogenic bacterium infecting incision,and certainly resistant to quinolone-like drugs.