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目的分析肝硬化并自发性腹膜炎腹水培养的病原菌及耐药性。方法 90例肝硬并自发性腹膜炎患者,均对患者抽取腹水并行病原菌培养,同时分析病原菌的耐药性。结果 90例患者经腹水培养分离出92株病原菌,革兰阴性菌67株,占72.8%;革兰阴性菌中以大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌为主,革兰阳性菌23株,占25.0%;革兰阳性菌中以表皮葡萄球菌为主。大肠埃希菌及肺炎克雷伯菌对青霉素类阿莫西林、氨苄青霉素等抗生素以及三代头孢菌素类药物具有较高耐药性,对阿米卡星、头孢哌酮/舒巴坦具有较低耐药性,对亚胺培南无耐药性。表皮葡萄球菌对青霉素类抗生素具有较高的耐药性,对三代头孢菌素类抗生素及四代头孢菌素类抗生素的耐药性较低,对亚胺培南无耐药性。结论掌握肝硬化并自发性腹膜炎病原菌,选择敏感度较高、耐药性较低的抗生素,可提高患者治疗效果。
Objective To analyze the pathogens and drug resistance of cirrhosis with spontaneous peritonitis and ascites culture. Methods Ninety patients with cirrhosis and spontaneous peritonitis were enrolled in this study. The ascitic fluid was collected from patients with ascites and the pathogenic bacteria were analyzed. Results Ninety-nine pathogenic bacteria and 67 gram-negative bacteria were isolated from ascites fluid in 90 patients, accounting for 72.8%. Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were the main pathogens in Gram-negative bacteria. Gram-positive 23 strains of bacteria, accounting for 25.0%; Gram-positive bacteria Staphylococcus epidermidis-based. Escherichia coli and Klebsiella pneumoniae to penicillins amoxicillin, ampicillin and other antibiotics and third-generation cephalosporins drugs with high resistance to amikacin, cefoperazone / sulbactam have more Low resistance, no resistance to imipenem. Staphylococcus epidermidis has high resistance to penicillin antibiotics, low resistance to third-generation cephalosporin antibiotics and fourth-generation cephalosporin antibiotics, and no resistance to imipenem. Conclusion Grasp the pathogens of cirrhosis and spontaneous peritonitis, the choice of high sensitivity and low antibiotic antibiotics, can improve the therapeutic effect of patients.