前庭大腺脓肿病原菌分布及耐药性分析

Pathogen distribution and drug resistance analysis in bartholinian gland abscess

目的分析温州地区临床诊断为前庭大腺脓肿患者的病原菌分布和耐药性情况,为临床诊断和治疗提供理论依据。方法收集温州市人民医院2016年1月—2022年9月临床诊断为前庭大腺脓肿的患者脓液标本183份。采用基质辅助激光解析电离-飞行时间质谱仪MALDI-TOF(VITEK MS)进行病原菌鉴定,采用VITEK 2 Compact全自动鉴定药敏仪和纸片扩散法(K-B法)进行药敏试验,对病原菌分布和耐药性进行回顾性分析。结果共183份标本,检出92株病原菌,检出率为50.27%。革兰阴性菌50株,占54.35%,革兰阳性菌34株,占36.96%,真菌6株,占8.70%。革兰阴性菌以大肠埃希菌为主,对哌拉西林/他唑巴坦、阿米卡星、头孢吡肟的敏感性较好;革兰阳性菌以无乳链球菌和咽峡炎链球菌为主,对青霉素、利奈唑胺、万古霉素敏感性较好,金黄色葡萄球菌和表皮葡萄球菌对青霉素耐药性高;产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌及耐甲氧西林金黄色葡萄球菌的检出率分别为20.0%、33.3%、33.3%。结论前庭大腺脓肿感染患者标本中的病原菌以大肠埃希菌为主,临床医生需根据实际药敏结果合理使用抗菌药。

Objective This paper aims to analyze the distribution and drug resistance of pathogenic bacteria in patients with clinically diagnosed bartholin gland abscess in Wenzhou,so as to provide theoretical basis for clinical diagnosis and treatment.Methods From January 2016 to September 2022,183 pus samples were collected from patients diagnosed with bartholin gland abscess in Wenzhou People's Hospital.Matrix-assisted laser desorption ionization-time-of-flight mass spectrometer MALDI-TOF(VITEK MS)was used for pathogen identification,and VITEK 2 Compact automatic drug sensitivity analyzer and disk diffusion method(K-B method)were used for drug sensitivity test.The distribution and drug resistance of pathogens were analyzed retrospectively.Results A total of 183 specimens were collected,92 strains of pathogenic bacteria were detected,and the detection rate was 50.27%.Among them,50 strains of Gram-negative bacteria accounted for 54.35%,34 strains of Gram-positive bacteria accounted for 36.96%,and 6 strains of fungi accounted for 8.70%.The Gram-negative bacteria were mainly Escherichia coli,which were sensitive to piperacillin/tazobactam,amikacin and cefepime.Streptococcus agalactiae and Streptococcus angina were the main gram-positive bacteria,which were sensitive to penicillin,linezolid and vancomycin.Staphylococcus aureus and Staphylococcus epidermidis were highly resistant to penicillin.The detection rates of ESBLs producing Escherichia coli,Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus were 20.0%,33.3% and 33.3%,respectively.Conclusion Escherichia coli is the main pathogenic bacteria in the specimens of patients with bartholin gland abscess infection.Clinicians should use antimicrobial drugs rationally according to the clinical drug sensitivity results.