我院肛瘘合并感染患者脓液病原菌培养和药敏结果分析

Analysis of Pus Pathogenic Bacteria Culture and Drug Susceptibility in Patients with Anal Fistula Complicated with Infection in Our Hospital

目的:探讨我院肛瘘合并感染患者脓液病原菌培养和药敏结果,旨在为肛瘘临床合理用药提供理论参考。方法:回顾性分析2019年5月至2021年5月我院收治的174例肛瘘合并感染患者的临床资料,采集所有患者脓液标本进行病原菌培养,分析病原菌分布情况及主要病原菌药敏结果。结果:174例肛瘘合并感染患者共检出234株病原菌株,其中革兰阳性菌40株(占17.09%)、革兰阴性菌194株(占82.91%)。革兰阳性菌中以金黄色葡萄球菌为主(20株,占8.56%),革兰阴性菌中以大肠埃希菌为主(118株,占50.43%),其次为肺炎克雷伯菌(22株,占9.41%)。药敏结果显示,金黄色葡萄球菌对哌拉西林、万古霉素、利奈唑胺极为敏感(敏感率均为100%),而对青霉素、红霉素、利福平较为耐药(耐药率均>80%)。大肠埃希菌对大多数抗菌药物耐药,仅对阿米卡星、亚胺培南、美罗培南极为敏感(敏感率均为100%)。肺炎克雷伯菌亦对大多数抗菌药物耐药,仅对头孢他啶、哌拉西林、氨曲南、亚胺培南、美罗培南极为敏感(敏感率均为100%)。结论:我院肛瘘合并感染患者脓液病原菌主要以革兰阴性菌为主,检出率前3位的病原菌分别为大肠埃希菌、肺炎克雷伯菌及金黄色葡萄球菌,药敏结果显示,虽具有多种敏感性较高抗菌药物,但多为特殊抗菌药物,临床治疗时应采用以抗革兰阴性菌药物为主,并结合病原菌培养和药敏结果合理用药,提高治疗效果。

Objective:To investigate the culture and drug susceptibility results of pus pathogenic bacteria in patients with anal fistula complicated by infection in our hospital,to provide a theoretical reference for the clinical rational use of anal fistula.Methods:The clinical data of 174 patients with anal fistula complicated with infection admitted in our hospital from May 2019 to May 2021 were retrospectively analyzed.The pus samples of all patients were collected for pathogenic bacteria culture,and the distribution of pathogenic bacteria and the drug susceptibility results of main pathogenic bacteria were analyzed.Results:A total of 234 pathogenic bacteria strains were detected in 174 patients with anal fistula complicated with infection,including 40 gram-positive bacteria(17.09%)and 194 gram-negative bacteria(82.91%).Gram-positive bacteria were dominated by Staphylococcus aureus(20 strains,accounting for 8.56%),gram-negative bacteria were dominated by Escherichia coli(118 strains,accounting for 50.43%),followed by Klebsiellapneumoniae(22 strains,accounting for 9.41%).The drug susceptibility results showed that Staphylococcus aureus was extremely sensitive to piperacillin,vancomycin,and linezolid(the sensitivity rate was all 100%),while it was relatively resistant to penicillin,erythromycin,and rifampicin(resistant to drug rates were>80%).Escherichia coli showed resistance to most antibacterial drugs,and only showed extreme sensitivity to amikacin,imipenem and meropenem(the sensitivity rate was all 100%).Klebsiellapneumoniae also showed resistance to most antibacterial drugs,and only showed extreme sensitivity to ceftazidime,penicillin,aztreonam,imipenem,and meropenem(the sensitivity rate was all 100%).Conclusion:The pathogenic bacteria in the pus of patients with anal fistula complicated with infection were mainly gram-negative bacteria.The top three pathogenic bacteria in the detection rate were Escherichia coli,Klebsiellapneumoniae and Staphylococcus aureus.There are a variety of antibiotics with high sensitivity,but most of them are special antibiotics.In clinical treatment,anti-gram-negative bacteria drugs should be mainly used,and rational use of drugs should be combined with the results of pathogenic bacteria culture and drug susceptibility to improve the therapeutic effect.