369例乳腺炎患者病原菌分布及药敏分析

Distribution of pathogens and their antibiotic resistance in 369 patients with mastitis

目的分析乳腺炎患者病原菌分布情况及药敏结果,为临床诊断提供实验依据,根据药敏结果指导临床治疗用药。方法对广东省妇幼保健院2019年1月—2020年12月乳腺科诊断为乳腺炎的369名患者的脓液或穿刺液标本进行细菌培养,分离出病原菌,并做相关体外菌种鉴定和药物敏感性试验。结果369名乳腺炎患者中有177名患者细菌培养阳性,阳性率为48.0%。分离鉴定出的致病菌以金黄色葡萄球菌为主,有114株(占64.4%)。其中鉴定为MRSA的有56株(占49.1%)。金黄色葡萄球菌中96.5%产β-内酰胺酶,药敏结果显示对青霉素、苯唑西林、克林霉素、红霉素的耐药率分别为97.4%、49.1%、60.5%、64.0%;对莫西沙星、利奈唑烷、替加环素、万古霉素100%敏感。结论金黄色葡萄球菌是育龄妇女急性乳腺炎的主要病原体。在抗菌药物的选择上,根据药敏结果合理选择抗菌药物对患者的治疗和减少细菌耐药的产生具有重要意义。

Objective To explore the distribution of pathogens and antibiotic susceptibility in patients with mastitis for rational use of antibiotics in clinic.Methods 369 samples from the galactophore department of Guangdong Women And Children Hospital from January 2019 to December 2020 were cultured,isolated pure strains were identified and their drug-susceptibility tests were done by VITEK-2 compact advanced automated ID/AST system.Results A total of 177 strains were isolated from 369 specimens(48.0%).The major pathogens were Staphylococcus aureus(114).96.5%of Staphylococcus aureus producedβ-Lactamases.The antibiotic resistance to penicillin,oxacillin,clindamycin and erythromycin stood at 97.4%,49.1%,60.5%and 64.0%respectively.The antibiotics resistance to moxifloxacin,linezolid,tigecycline,vancomycin was zero.MRSA occurrence rate was 49.1%.Conclusion Staphylococcus aureus were the main pathogenic bacteria in mastitis.Rational use of antibiotics according the drug sensitivity tests has great significance for treatment of patients and decreased occurrence of drug-resistant bacteria.