摘要
目的了解肝移植患者术后感染革兰阴性杆菌(G-杆菌)的分布及其耐药性,供临床治疗借鉴。方法采用回顾性分析2003年9月至2005年11月间,从我院肝移植中心103例肝移植术后患者送检的标本中分离到的467株G-杆菌的分布及其耐药情况。结果G-杆菌中,肠杆菌科占77.9%(364/467),最多前3种是大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌,非发酵菌占22.1%(103/467),最多前3种是嗜麦芽假单胞菌、铜绿假单胞菌、恶臭假单胞菌,检出产ESBLs菌148株,检出率为31.7%(148/467),产ESBLs最严重的细菌分别是铜绿假单胞菌(45.7%)、阴沟肠杆菌(41.8%)、嗜麦芽假单胞菌(40.54%)、肺炎克雷伯菌(34.9%)、大肠埃希菌(32.3%),肠杆菌科耐药率最高依次为哌拉西林、氨苄西林、替卡西林、氨曲南,在89.66%-94.13%,耐药率较低依次是亚胺培南、环丙沙星、阿米卡星、头孢他啶,在5.45%-43.1%,非发酵菌耐药率最高是四环素、氨曲南、哌拉西林、头孢曲松,在59.84%-90.31%,耐药特率最低是阿米卡星、亚胺培南、妥布霉素、替卡西林/克拉维酸,在15.51%-27.63%。结论肝移植患者术后感染的G-杆菌产ESBLs菌高,耐药性严重,应引起关注。
Objective To find out the distribution and the resistance of gram-negative bacilli （ G^- bacilh） in the infected patient after liver transplantation, so as to be used for reference in clinic. Methods From September 2003 to November 2005, the distribution and the resistance of 467 G^-bacilli strains ,which were detected in the samples from 103 patients underwent liver transplantation in the liver transplantation center,were retrospectively analysed. Results Of the G^- bacilli,Enterobacteriaceae was up to 77.9% （364/467） ,and Escherichia coli,E, cloacae,P, maltophilia ,P. putida were the first three respectively, 148 strains which produce ESBLs were found, and it accounts for was 31.7% （ 148/467 ）. The most bacteria which produce ESBLs was P. aeruginosa （45.7%） ,E. c/acae（41.8% ） ,P. maltophilia （40.54%） ,P. maltophilia （34.9%） ,Escherichia call （32.3%） respectively. Resistance probability in the Enterobacteriaeea from high to low was piperaeillin, ampicillin, tieareillin, aztreonam, between 89.66 % - 94.31%. Low resistance probability in the Enterobacteriacea was imipenem, cip rofloxacin, amidacin, ceftazidine respectively, between 5.45% - 43.1%. Resistance probability in the Nonfermenters from high to low is tetracycline, aztreonam, piperaeillin, ceftriaxone, between 59.84% - 91.31%. Low resistance probability in the Nonfermenters was amikacin, imipenem, tobramycin, tieareillin/clavulanic, between 15.51% - 27.63%. Conclusions G^-bacilli in the infected patients after liver transplantation most produce EBSLs, and the resistance is serious. All should be pay attention.
出处
《中国微生态学杂志》
CAS
CSCD
2007年第1期63-64,共2页
Chinese Journal of Microecology
关键词
肝移植
细菌感染
耐药性
Liver transplantation
Bacterial infection
Resistance
