儿童穿孔性阑尾炎脓液培养及药敏报告

目的分析小儿穿孔性阑尾炎致病细菌及药敏情况，为临床合理应用抗生素提供依据。方法2008年6月～2010年6月，我院共108例小儿因穿孔性阑尾炎接受手术治疗，其中98例在术中采集腹腔渗液标本，进行细菌培养及药敏试验。回顾分析培养阳性的83株需氧菌及药敏结果。结果小儿穿孔性阑尾炎主要致病细菌仍以大肠埃希菌为主，其药物敏感率由高到低依次为亚胺培南、呋喃妥因、哌拉西林／他唑巴坦、环丙沙星、左旋氧氟沙星、马斯平、氨曲南、头孢他啶、头孢曲松、头孢唑啉、庆大霉素、妥布霉素、氨苄西林舒巴坦、氨苄西林和复方新诺明。结论目前小儿穿孔性阑尾炎主要致病细菌仍为大肠埃希菌，对临床常用的抗生素有较高的耐药性，而且菌株耐药性有所增加。抗生素的选用主张以脓液细菌培养为指导。

Report of Pus Bacteria Culture and Drug Sensitivity Test in Children with Perforated Appendicitis

Objective To analyze the major pathogenic bacteria and drug sensitivity in children with perforated appendicitis, and to supply the foundation of clinical selection of reasonable antibiotics. Methods From June 2008 to June 2010, totally 108 cases underwent appendectomy, and the abdominal cavity pus specimens of 98 cases were collected during the operations. The Results of bacteria culture and drug sensitivity from 83 positive specimens are retrospectively analyzed. Results The major pathogenic bacteria was still Escherichia coli in childhood perforated appendicitis, and the drug sensitivity rates from high to low were Imipenem, Nitrofurantoin, Compound piperacillin, Ciprofloxacin levofloxacin, Maxipime, Aztreonam, Ceftazidime, Ceftriaxone, C~fazolin, Gentamycin, Tobramycin, Ampicillin - sulbactam, Ampicillin and SMZ. Conclusion Escherichia coli is still the major pathogenic bacteria in childhood perforated appendicitis, with higher resistance rate to routine antibiotics. Pus bacteria culture is the guidance in the antibiotic treatment in ehildren with perforated appendicitis.