连续六年肛周脓肿需氧菌耐药性分析

目的：探讨佛山市中医院肛周脓肿患者脓液需氧菌的菌群分布及药敏特征，动态观察其主要病原菌对抗菌药物的耐药变化特点。方法：对该院2006-2011年肛肠科送检的首次入院病人的肛周脓肿患者脓液标本进行常规微生物培养鉴定和药敏试验并统计分析。结果：2006-2011年从肛周脓肿患者脓液中共检出需氧菌299株，以革兰阴性菌为主（79.6%），其中大肠埃希菌居首位（58.5%），其次为肺炎克雷伯菌（12.0%）；革兰阳性菌以链球菌为主（10.7%），其次是金黄色葡萄球菌（2.7%）。大肠埃希菌和肺炎克雷伯菌对亚胺培南、头孢西丁和阿米卡星敏感性较高；万古霉素、青霉素G和左氧氟沙星对链球菌敏感性较高。金黄色葡萄球菌全对复方新诺明、万古霉素、左氧氟沙星、苯唑西林和米诺环素100%敏感，而对青霉素100%耐药。大肠埃希菌产ESBLs的检出率呈波动性变化，总体呈缓慢上升态势。结论：肛周脓肿患者脓液标本需氧菌以大肠埃希菌占首位，其多重耐药处于上升态势，需氧菌中各病原菌对抗菌药物的敏感性差异较大。临床应重视标本送检，不可忽视厌氧菌的培养。

Aerobic bacteria drug resistance analysis in patients with perianal abscess for six consecutive years

Objective：To explore the distribution and drug resistance of aerobic flora in patients with perianal abscess recruited from Hospital of Foshan City, Guangdong Province. Additionally, to observe dynamic changes of the main pathogens in regards to antimicrobial drug resistance. Methods：From 2006 to 2011, a total of 100 hospitalized patients with perianal abscesses were recruited from the Hospital of Foshan City for this study. Pus specimens were collected for routine microbiological culture identification and drug susceptibility testing and the results were analyzed using the student T test.Results：A total of 299 aerobic bacteria strains were detected in patients with perianal abscess pus, mainly Gram-negative bacteria （79.6%）, which ranks first in Escherichia coli （58.5%）, followed by Klebsiella pneumoniae andReber bacteria （12.0%）;Also found were Gram-positive bacteria, led bystreptococcus （10.7%） and Staphylococcus aureus （2.7%）. Escherichia coli and Klebsiella pneumoniae have a higher sensitivity to Imipenem, cefoxitin, and amikacin. Streptococcus has a high sensitivity to vancomycin, penicillin G and levofloxacin. Notably, Staphylococcus aureus has 100%sensitivity to cotrimoxazole, vancomycin, levofloxacin, oxacillin, and minocycline and is 100%resistant to penicillin. The detection rate of ESBLs in Escherichia coli fluctuated, although a slow upward trend showed, overall.Conclusions：Aerobic Escherichia coli is the dominant strain detected in patients with perianal abscess pus. The increase of multiple drug resistance and the sensitivity of pathogenic aerobic bacteria to antimicrobial agents differ. Much attention should be paid to the detection of these pathogens in clinical specimens and the cultivation of the anaerobic bacteria should be included.