2015-2017年某院肛周脓肿病人脓液的病原菌及药敏情况分析

Analysis of pathogenic bacteria and drug sensitivity of purulent fluid in patients with perianal abscess in a hospital from 2015 to 2017

目的了解肛周脓肿相关致病菌的分布及其药敏情况,为临床抗菌药物的应用提供依据,从而提高疗效。方法选择2015年1月~2017年12月在唐山市中医医院拟行切开引流术肛周脓肿病人276例,收集脓液标本进行细菌培养与药敏分析,了解病原菌的分布情况和细菌的耐药性。结果 276份标本中分离出病原菌285株,其中革兰阴性菌232株(占81. 40%);革兰阳性菌43株(占15. 09%);真菌10株(占3. 51%)。285株细菌中大肠埃希氏菌116株(占40. 70%),其次是肺炎克雷伯菌60株(占21. 05%)。革兰阴性菌的前3种敏感抗菌药物是阿米卡星、美罗培南及亚胺培南,前3位耐药的抗菌药物是四环素、复方新诺明及哌拉西林;革兰阳性菌的前3种敏感抗菌药物是亚胺培南、万古霉素和左氧氟沙星;前3位耐药的抗菌药物是阿莫西林、氨苄西林及青霉素。多重耐药菌的出现率为18. 60%。结论肛周脓肿的病原菌主要是革兰阴性菌中的大肠埃希氏菌,多重耐药菌的占比很高,临床应根据药敏分析结果合理用药。

Objective To get an insight into the distribution of pathogenic bacteria in perianal abscess patients and its drug sensitivity,and to provide evidence for the application of clinical antibiotics,thereby improving the efficacy.Methods Between January 2015 and December 2017,276 patients with perianal abscess were treated with incision and drainage in Tangshan Traditional Chinese Medicine Hospital.Pus specimens were collected for bacterial culture and drug sensitivity analysis to understand the distribution of pathogenic bacteria and bacteria resistance.Results 285 strains of pathogenic bacteria were isolated from 276 specimens,including 232 Gram-negative bacteria(81.40%),43 Gram-positive bacteria(15.09%)and 10 fungi(3.51%).Among the 285 strains of bacteria,there were 116 strains of Escherichia coli(40.70%),followed by 60 strains of Klebsiella pneumoniae(21.05%).In Gram-negative bacteria,the first three sensitive antibacterial agents were amikacin,meropenem and imipenem.The first three drug-resistant antibacterial agents were tetracycline,compound sinomin and piperacillin.In Gram-positive bacteria,the first three sensitive antimicrobial agents were imipenem,vancomycin and levofloxacin.The top three drug-resistant antimicrobial agents were amoxicillin,ampicillin and penicillin.The incidence of multi-drug resistant bacteria was18.60%.Conclusion The pathogen of perianal abscess is mainly Escherichia coli in Gram-negative bacteria,and the proportion of multi-drug resistant bacteria is very high.Medicine should be rationally used in clinical practice according to the results of drug sensitivity analysis.