摘要
目的了解肝硬化合并自发性细菌性腹膜炎(SBP)患者的病原菌及其耐药情况。方法对56例肝硬化合并自发性细菌性腹膜炎细菌培养阳性者进行分析。结果肝硬化患者合并SBP的病原菌为革兰阴性菌,占64.28%,其中大肠埃希菌占35.71%,其次为肺炎克雷伯菌占16.07%;革兰阳性菌占32.15%,主要是金黄色葡萄球菌(12.50%)、表皮葡萄球菌(8.93%)和粪肠球菌(5.36%);白色假丝酵母菌2株(3.57%);三代头孢菌素与三代喹诺酮类药物的耐药率明显增加,而临床上使用较少的氨基糖苷类抗菌药物对大肠埃希菌的耐药率较低;美罗培南、亚胺培南、替考拉宁和万古霉素的耐药率低。结论尽可能对肝硬化患者合并腹水患者进行腹腔穿刺检查,根据药敏试验结果合理选择抗菌药物。
OBJECTIVE To know the pathogens of spontaneous bacterial peritonitis （SBP） in cirrhosis patients and their drug resistance. METHODS The SBP with positive bacterial culture in 56 cases of liver cirrhosis was analyzed. RESULTS The pathogens of Gram-negative bacteria accounted for 64.28%,of which Escherichia coli accounted for 35.71%,followed by Klebsiella pneumoniae for 16.07%. Gram-positive bacteria accounted for 32.15% ,mainly Staphylococcus aureus （12.50%）,S. epidermidis （8.93%） and Enterococcus faecalis （ 5.36% ）. Two cases were with Candida albicans （3.57%）. The resistance rates to the to third generation cephalosporins and three generations of quinolones were increased significantly,while the less used aminoglycosides clinically had lower resistance rates for E. coli. Meropenem,imipenem,teicoplanin and vancomycin were all with olw resistance rate. CONCLUSIONS The abdominopentesis must be used in liver cirrhosis patients with ascites as far as possible,must be reasonably selected according to antimicrobial susceptibility test of antimicrobial agents.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第5期653-654,共2页
Chinese Journal of Nosocomiology
关键词
肝硬化
自发性细菌性腹膜炎
Liver cirrhosis
Spontaneous bacterial peritonitis
