新疆某医院肝硬化合并细菌感染的病原菌分析

Analysis of pathogenic bacteria in cirrhotic patients complicated with bacterial infection in a tertiary hospital in Xinjiang

目的了解新疆某医院肝硬化患者合并细菌感染病原菌种类、分布及耐药程度。方法回顾分析1271例肝硬化患者合并感染时病原菌种类及不同菌属耐药情况。结果1271例肝硬化患者其中合并感染患者为480例,感染率为37.8%,感染患者中失代偿期居多(438例)。常见感染部位为腹膜(327例,60.8%),其次为肺部(16.9%)等。在480例感染患者中,分离出343株病原体,其中非重复细菌中前10种常见细菌有289株,革兰阴性菌占76.5%,革兰阳性菌占23.5%,前3种菌株为大肠埃希菌(33.2%)、肺炎克雷伯菌(11.4%)、屎肠球菌(11.1%),且各菌属耐药率不同。结论新疆某三甲医院失代偿期肝硬化患者细菌感染率高,病原菌种类多样,主要为革兰阴性菌感染,但肠球菌等革兰阳性菌感染率逐渐增加。根据细菌属性分为4类(肠杆菌、肠球菌、非发酵糖菌及葡萄球菌),发现即使同种菌属耐药率都不相同。

Objective To understand the species,distribution,and extent of drug resistance of pathogenic bacteria in patients with liver cirrhosis combined with bacterial infection in a tertiary hospital in Xinjiang.Methods 1271 cases with liver cirrhosis combined with infection were analyzed retrospectively for pathogenic bacterial species and drug resistance condition in different bacterial strain.Results Among the 1271 cases with liver cirrhosis,480 were combined with infection,and the infection rate was 37.8%.The majority of infected patients had decompensated cirrhosis(438 cases).Peritoneum(327 cases,60.8%)was the common infection site,followed by lungs(16.9%).343 strains of pathogens were isolated from 480 infected cases,of which 289 strains were among the top 10 common distinct bacteria,accounting for 76.5%and 23.5%of Gram-negative and positive bacteria.The first top three strains were Escherichia coli.(33.2%),Klebsiella pneumoniae(11.4%),and Enterococcus faecium(11.1%),and there were differences in the drug resistance rates of each strain.Conclusion In a tertiary hospital in Xinjiang,patients with decompensated cirrhosis have a high rate of bacterial infection.The pathogenic bacteria are diverse,mainly Gram-negative bacteria;however,the infection rate of Gram-positive bacteria such as Enterococcus is gradually increasing.Additionally,according to the bacterial properties,they are divided into four categories:Enterobacter,Enterococcus,glucose non-fermenting bacteria and Staphylococcus,and it is found that even the same species of bacteria have different drug resistance rates.