小儿腹膜炎的细菌学调查和抗生素应用

Bacteriological Study and Antibiotic Therapy for Peritonitis in Children

小儿腹膜炎是非常重笃的疾患,尤其是新生儿消化道穿孔引起的弥漫性腹膜炎.查明引起腹膜炎的细菌,选择最合适的抗生素是极为重要.

This paper reports the bacteriological survey data of 119 cases of acute peritonitis in children(1980-1984). The bacteriological cultures showed that 111 samples were positive(93.2%). 110/119samples were aerobic(92.4%), with 154 aerobic strains, mostly Gram negative bacilli and Gram positive cocci, especially E, coli and various streptococcal strains. And 48/69 samples were anaerobic organisms(68.8%)consisring of 68 strains, mostly being Gram negative bacilli, especially bacteroids fragilis. The majority of the cases were mixed infection of aerobic and anaerobic organisms. The isolation rate of anaerobic organisms in perforation of the upper alimentary tract was 25%in ileum, 77% in appendix, and 50% in colon. Aerobic E. coli was sensitive to Aminoglycoside, while anaerobic bacteroids fragilis was sensitive to Metronidazole, Rifampin and Lincomycin. The authors conclude that combination of Ampicillin and Aminoglycoside is the most effective chemotherapy in cases of perforation of the upper gastrointestinal tract, and so is the combination of Aminoglycoside and Metronidazole of Lincomycin in cases of the perforated lower intestinal tract.