肝硬化伴自发性腹膜炎感染大肠埃希菌的耐药性分析

目的探讨肝硬化伴自发性腹膜炎（SBP）感染大肠埃希菌的耐药性。方法选择肝硬化伴SBP患者腹水中分离出的72株大肠埃希菌，采用双纸片协同扩散法测定超广谱β-内酰胺酶（ESBLs），采用K—B法检测其对15种抗生素的耐药率。结果从72株大肠埃希菌中检出ESBLs阳性菌株38株（52．8％）。除亚胺培南外，ESBLs阳性菌株对15种抗生素耐药性均高于ESBLs阴性菌株（P〈0．05或P〈0．01）。结论肝硬化伴SBP患者腹水感染大肠埃希菌对抗生素耐药的主要原因是产生ESBLs。头孢吡肟、头孢西丁、哌拉西林，他唑巴坦和头孢哌酮／舒巴坦可作为首选药物，重症感染首选亚胺培南。

Antibiotic resistance of escherichia coli in cirrhosis patient with spontaneous bacterial peritonitis

Objective To explore the antibiotic resistance of escherichia coli in cirrhosis patient with spontaneous bacterial peritonitis(SBP).Methods Seventy-two strains of escherichia were seperated from ascites of cirrhosis patients with SBP.Double disk synergy test was used to detect ESBLs,Kirby bauer agar diffusion method was used to judge drug sensitivity to 15 antibiotics.Results The detection rate of ESBLs-producing bacteria was 52.8%(38 strains).Except to imipenem,the resistance rates of ESBLs producing strains to 15 antibiotics were much hgither than that of none ESBLs producing strains(P < 0.05 or P < 0.01).Conclusion ESBLs-producing maybe the main reason of the drug resistance of escherichia coli in cirrhosis patients with SBP.So we can clinically choose antibiotics as kinds of cefepime,cefepime,piperacillin/tazobactam and cefoperazone/sulbactam,and can choose imipenem as the first choice for severe infection.