急性阑尾炎患者脓液细菌培养结果及耐药性

目的了解引起急性阑尾炎患者感染的病原菌的分布及感染菌对药物的耐药性,指导临床合理用药。方法用ATB Expression细菌鉴定仪对116例急性阑尾炎患者行阑尾切除术中,采集脓液标本做细菌培养及药敏试验。结果116例标本中有75例检出细菌,阳性率为64.7%,分离到细菌85株(其中10例为两种细菌混合感染),其中革兰阴性菌72株(84.7%),革兰阳性菌13株(15.3%);从分离到的细菌看,前3位是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌肺炎亚种,分别占检出病原菌的54.1%、4.7%、4.7%;药敏试验结果:大肠埃希菌对头孢匹林、亚胺培南、哌拉西林/他唑巴坦、头孢西丁、阿米卡星的耐药率分别为0、2.2%、10.9%、17.4%、23.9%。结论急性阑尾炎患者感染菌中以肠杆菌为主,其中以大肠埃希菌占首位;应加强临床病原菌的检测和药敏试验,减少耐药菌株产生和预防医院感染发生。

Pus Germicultures and Drug Sensitivity Tests in Patients with Acute Appendicitis

OBJECTIVE To investigate the distribution of acute appendicitis pathogens and their drug resistance,and to guide clinically the selection of reasonable antibiotics.METHODS Germicultures and drug sensitivity tests were conducted for the pus specimens from the 116 patients with acute appendicitis by ATB Expression bacteria(identifier).RESULTS Pathogens in 75 cases of 116 were found,with a positive rate of 64.7%,totally 85 strains of bacteria were isolated from clinical samples.Gram-negative bacilli had 72 strains,accounted for 84.7% and Gram-positives had 13 strains,(accounted) for 15.3%.The first three were Escherichia coli(54.1%),Pseudomonas aeruginosa(4.7%),and Klebsiella pneumoniae(4.7%).Sensitivity tests showed that resistance rates of E.coli to cefapirin,imipenem,compound(piperacillin),cefoxitin,and amikacin were 0,2.2%,10.9%,17.4%, and(23.9%).CONCLUSIONS Dominant pathogens in patients with acute(appendicitis) are intestinal bacilli,with(predominance) of E.coli;more emphasis should be placed on pathogen detections and drug sensitivity tests so that effective antibiotics could be selected and resistant bacteria be reduced and nosocomial infections be prevented.