腹腔感染病原菌及其耐药性

目的了解腹腔感染病原菌构成及其耐药性,为临床腹腔感染的治疗提供参考依据。方法对某院2011年1月—2013年12月住院患者送检的腹腔感染标本进行菌种鉴定及药物敏感性检测,并将数据输入WHONET5.6软件进行统计分析。结果 15 946份腹腔感染标本分离非重复病原菌810株,培养阳性率5.08%;革兰阴性杆菌485株(59.88%),革兰阳性菌275株(33.95%),真菌50株(6.17%);居前5位的病原菌分别为大肠埃希菌(24.20%)、屎肠球菌(15.06%)、鲍曼不动杆菌(8.89%)、肺炎克雷伯菌(7.66%)和凝固酶阴性葡萄球菌(6.91%)。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为59.18%和32.79%,各种肠杆菌科细菌对亚胺培南仍高度敏感,但对碳青霉烯类耐药的菌株占4.08%~6.67%;多重耐药鲍曼不动杆菌占52.11%(37/71),耐甲氧西林金黄色葡萄球菌(MRSA)占53.57%(15/28),耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占71.43%(40/56),耐万古霉素屎肠球菌(VRE)占8.26%。结论该院腹腔感染病原菌主要是以大肠埃希菌为代表的革兰阴性菌,屎肠球菌是最常见革兰阳性致病菌,细菌耐药形势严峻。

Distribution and antimicrobial resistance of pathogens causing intra abdominal infection

ObjectiveTo understand the constituent and antimicrobial resistance of pathogens causing intra abdominal infection, so as to provide reference for clinical treatment of intra abdominal infection.MethodsPathogens causing intra abdominal infection in patients in a hospital from January 2011 to December 2013 were identified and performed antimicrobial susceptibility testing, and results were analyzed with WHONET5.6 software.ResultsA total of 810 non repeated strains were isolated from 15 946 intra abdominal specimens, isolation rate was 5.08%; isolation rates of gram negative bacilli, gram positive bacteria, and fungi were 59.88%(n=485), 33.95% (n=275), and 6.17%(n=50) respectively; the top five pathogens were Escherichia coli (E. coli,24.20%), Enterococcus faecium (E. faecium, 15.06%), Acinetobacter baumannii (A. baumannii, 8.89%), Klebsiella pneumoniae (K. pneumoniae, 7.66%), and coagulase negative staphylococcus (CNS, 6.91%). The detection rates of extended spectrum β 1actamases(ESBLs) in E. coli and K. pneumoniae were 59.18％ and 32.79％ respectively. Enterobacteriaceae were still highly sensitive to imipenem, but carbapenem resistant Enterobacteriaceae strains accounted for 4.08%-6.67% ; multidrug resistant A. baumannii accounted for 52.11%（37/71）, methicillin resistant strains in Staphylococcus aureus and CNS accounted for 53.57％（15/28） and 71.43％（40/56） respectively, resistance rate of E. faecium to vancomycin was 8.26%.ConclusionThe main pathogens causing intra abdominal infection in this hospital are gram negative bacilli, especially E. coli, while E. faecium is the most common gram positive pathogen, antimicrobial resistance of bacteria is still serious.