518株急性阑尾炎病原菌分布及药敏结果分析

目的:调查了解急性阑尾炎病人感染的细菌学分布及耐药情况,以指导临床用药。方法:利用WHONET5.6对2008年1月-2011年6月急性阑尾炎病人阑尾切除术中取脓液细菌培养及药敏试验结果进行回顾性分析。结果:481例细菌培养阳性标本共分离出518株(34种)病原菌,主要是大肠埃希菌349株(67.37%)、铜绿假单胞菌50株(9.65%)、肺炎克雷伯菌22株(4.25%);大肠埃希菌产超广谱β-内酰胺酶(ESBLs)122株(35.0%),产酶株和非产酶株在青霉素类,头孢菌素类、氟喹诺酮、磺胺类以及庆大霉素、氨曲南和头孢西丁间有显著性差异(P<0.01)。结论:急性阑尾炎病人病原菌以革兰阴性菌为主,其中大肠埃希菌最多见;临床上应尽量根据药敏试验结果选用抗生素,避免不合理用药。

Analysis of bacterial spectrum and susceptibility tests of 518 strains from patients with acute appendicitis

Objective:To understand the bacterial distribution and drug resistance in patients with acute appendicitis for guidance of clinical medication.Methods: A retrospective analysis was carried out among the pus culturing results of patients with acute appendicitis during the period from January 2008 to June 2011 with WHONET 5.6 software.Results: Of the 481 specimens with bacteria,518 strains(34 species) were isolated,349 strains of(67.37%) Escherichia coli,50 strains of(9.65%)Pseudomonas aeruginosa and 22 strains of(4.25%) Klebsiella pneumonia,and 122 strains of(35.0%) Escherichia coli producing extended spectrumβ-actamase(ESBLs),the drug resistance of penicillins,cephalosporins,fluoroquinolones,sulfonamides,gentamicin,aztreonam and cefoxitin between ESBLs(+) and ESBLs(-) were statistically significant(P<0.01).Conclusion: The pathogenic bacteria of acute appendicitis are mainly Gram negative,mostly Escherichia coli.Antibiotics should be applied according to the drug sensitivity tests to avoid inappropriate use.