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目的探讨肝硬化腹腔积液并自发性细菌性腹膜炎(SBP)患者的病原菌分布及其耐药率。方法对186例腹腔积液细菌培养阳性的肝硬化腹腔积液合并SBP患者的病原菌分布及药物敏感性检测结果进行回顾性分析。结果共检出致病菌208株,10个菌种。其中革兰阴性菌126株(60.58%),以大肠埃希菌62株(49.21%)、肺炎克雷伯杆菌32株(25.40%)为主;革兰阳性菌82株(39.42%),以金黄色葡萄球菌38株(46.34%)、表皮葡萄球菌22株(26.83%)为主。致病菌对亚胺培南、比阿培南、美洛培南的耐药率最低,其次是哌拉西林他唑巴坦、莫西沙星、阿米卡星;对环丙沙星、诺氟沙星、氧氟沙星、青霉素、头孢唑林、头孢呋辛有较高的耐药率。结论肝硬化腹腔积液并SBP的主要病原菌以革兰阴性菌为主,其中大肠埃希菌是最主要的致病菌,对头孢类及喹诺酮类抗菌药物的耐药性较高。
Objective To investigate the distribution and drug resistance rate of pathogens in patients with cirrhosis and spontaneous bacterial peritonitis (SBP). Methods 186 cases of ascites bacterial culture positive cirrhosis with ascites and SBP in patients with pathogenic bacteria distribution and drug sensitivity test results were retrospectively analyzed. Results A total of 208 pathogenic bacteria and 10 bacterial strains were detected. Among them, 126 strains (60.58%) of Gram-negative bacteria were Escherichia coli, 62 (49.21%) were Escherichia coli and 32 (25.40%) were Klebsiella pneumonia. 82 strains (39.42%) of gram- Staphylococcus aureus 38 (46.34%), Staphylococcus epidermidis 22 (26.83%) based. The resistance rate of pathogenic bacteria to imipenem, biapenem and meropenem was the lowest, followed by piperacillin, tazobactam, moxifloxacin and amikacin. For ciprofloxacin, Ofloxacin, ofloxacin, penicillin, cefazolin, cefuroxime have a higher resistance rate. Conclusions Gram-negative bacteria are the major pathogens of the liver cirrhosis with ascites and SBP. Escherichia coli is the most important pathogenic bacteria, and resistant to cephalosporins and quinolone antibiotics is high.