摘要
目的 探讨外科重症监护病房腹腔镜内感染的病原菌分布及其耐药性变化。方法 回顾总结 1998年 6月 - 2 0 0 0年 9月收治的 73例AII患者 ,共分离出腹腔内病原菌 117株 ,并对常用抗生素药敏结果进行分析。结果 革兰阴性菌、革兰阳性菌和真菌分别占 6 5 .0 %、2 6 .5 %和 8.5 %。其中最主要的病原菌依次是大肠埃希菌 (17.1% )、葡萄球菌属 (16 .2 % )、假单胞菌属 (13.7% )、肠杆菌属(12 .8% )、真菌 (8.5 % )、肠球菌 (8.5 % )、克雷伯菌属 (6 .8% )等 ,而大肠埃希菌和克雷伯菌中产ESBL的占 6 0 .7%。在全部检测的革兰阴性菌菌株中 ,泰能、头孢他定、丁胺卡那和环丙沙星的敏感性分别为 87.5 %、6 2 .5 %、5 6 .3%和 6 0 .0 % ;而革兰阳性菌对万古霉素均保持很高的敏感性 (97% )。结论 革兰阴性菌和念珠菌检出率有所上升 ,特别是多重耐药的大肠埃希菌、不动杆菌、阴沟肠杆菌、嗜麦芽假单胞菌更显著。碳青霉烯类和万古霉素仍是最有效的抗革兰阴性菌和阳性菌的药物。
Objective To investigate the changes of pathogen bacterial from acute intra-abdominal infection (AII) and their antibiotic resistance in surgical intensive care unit. Methods 117 pathogen strains from intra-abdominal in 73 AII patients during Jun. 1998 to Sep. 2000 were reviewed retrospectively, and their susceptibility to antimicrobial agents usually used in clinical practice was analyzed. Results The incidence of Gram-negative bacterial, Gram-positive bacterial and fungus was 65.0%, 26.5% and 8.5% respectively; major pathogens included E.coli (17.1%), Staphylococcus (16.2%), Pseudomonas (13.7%), Enterobacter (12.8%), Fungus (8.5%), Enterococcus (8.5%), Klebsiella (6.8%) and so on. ESBL's accounted for 60.7% in E.coli and Klebsiella. The sensitivity of Imipenem, Ceftazidme, Amikacin and Ciprofloxacin was 87.5%, 62.5%, 56.3% and 60.0% in Gram-negative bacterial, and Gram-positive bacterial (97%) were more sensitive to most Vancomycin. Conclusions The incidence of Gram-negative bacterium and fungus were increasing, and many multi-resistance bacterium, such as E.coli, Acinetobacter, Enterobacter cloacae, Xanthomonas maltophilia were more significant. Carbopenems and Vancomycin are still the most effective antibiotics in Gram-negative bacterium and Gram-positive bacterium.
出处
《消化外科》
CSCD
2003年第2期135-137,共3页
Journal of Digestive Surgery
关键词
腹腔内感染
病原菌
耐药性
intraabdominal infection pathogen bacterial antibiotics resistance
