76例狼疮性肾炎患者医院感染的病原菌分布与耐药性分析

Analysis on Pathogen Distribution and Drug Resistance of 76 Lupus Nephritis Patients with Hospital Infection

目的:分析76例狼疮性肾炎(Lupus nephritis,LN)患者医院感染的病原菌分布与耐药情况。方法:选取医院2018年7月—2020年10月收治LN患者76例资料,采集其感染相关分泌物样本,进行病原菌培养和药敏试验,分析其病原菌分布、主要革兰阳性菌和主要革兰阴性菌的耐药特点。结果:76例样本分离出85株菌株,其中革兰阳性菌52株(占61.18%,以金黄色葡萄球菌、表皮葡萄球菌为主)、革兰阴性菌25株(占29.41%,以大肠埃希菌、肺炎克雷伯菌为主);主要革兰阳性菌金黄色葡萄球菌对氨苄西林、磺胺甲噁唑-甲氧苄啶的耐药率较高,表皮葡萄球菌对磺胺甲噁唑-甲氧苄啶、庆大霉素和呋喃妥因的耐药率较高,二者对万古霉素无耐药;主要革兰阴性菌大肠埃希菌、肺炎克雷伯菌对氨苄西林、哌拉西林的耐药率较高,其中肺炎克雷伯菌对氨苄西林的耐药率为100.00%,对亚胺培南无耐药。结论:LN患者医院感染的病原菌大多为革兰阳性菌,其次为革兰阴性菌;临床应根据患者的病原菌培养结果和抗菌药物耐药情况,合理选用抗菌药物,以提高其临床疗效和改善预后。

Objective:To analyze the pathogen distribution and drug resistance of 76 patients with lupus nephritis(LN).Methods:Data of 76 patients with LN admitted to hospital from July 2018 to October 2020 were selected.Infection-related secretions samples were collected,and pathogen culture and drug sensitivity test were conducted to analyze the pathogens distribution,drug resistance rate of main gram positive and gram nagative bacteria.Results:85 strains were isolated from 76 samples,including 52 strains of gram positive bacteria(61.18%),most of which were Staphylococcus aureus and Staphylococcus epidermidis;25 strains of gram negative bacteria(29.41%),among which Escherichia coli and Klebsiella pneumoniae were the main strains.The main gram positive bacteria Staphylococcus aureus showed higher drug resistance rates to ampicillin and sulfamethoxazole-trimethoprim,and Staphylococcus epidermidis showed higher drug resistance rates to sulfamethoxazole-trimethoprim,gentamicin and furantoin,but they showed no drug resistance to vancomycin.The main gram negative bacteria Escherichia coli and Klebsiella pneumoniae showed higher drug resistance rates to ampicillin and piperacillin,in which Klebsiella pneumoniae showed 100.00%drug resistance rate to ampicillin and none drug resistance to imipenem.Conclusion:Most of the pathogens of nosocomial infection in LN patients were gram positive bacteria,followed by gram negative bacteria.In order to improve clinical efficacy and prognosis,antibacterials should be selected reasonably based on the results of pathogen culture and antibacterialresistance rate.