腹腔分离标本病原体构成及耐药性分析

发布时间：2018-08-02 12:40

【摘要】：目的监测我院2013—2015年腹腔分离标本病原体构成及耐药情况,为临床腹腔感染治疗提供参考依据。方法采用VITEK 2 Compact系统对病原菌进行鉴定,采用纸片法、MIC法和MTS法进行药敏试验,用WHONET5.6软件对结果进行分析。结果 3610份腹腔分离标本,培养获病原菌1408株,培养阳性率39.0%。剔除重复菌株后共983株病原菌,其中革兰阴性菌531株(54.0%),革兰阳性菌405株(41.2%),真菌46株(4.7%);居前5位的是大肠埃希菌、屎肠球菌、肺炎克雷伯菌、粪肠球菌、表皮葡萄球菌。金黄色葡萄球菌与凝固酶阴性葡萄球菌对甲氧西林耐药率分别为55.0%与76.1%,未发现对万古霉素、替考拉宁和利奈唑胺耐药的金黄色葡萄球菌。屎肠球菌的耐药率高于粪肠球菌,发现1株对万古霉素和利奈唑胺同时耐药屎肠球菌(VRE)。肠杆菌科细菌对碳青霉烯类、阿米卡星及加酶抑制剂复合制剂保持高度的敏感性,大肠埃希菌和肺炎克雷伯菌ESBLs检出率分别为56.3%和29.1%。铜绿假单胞菌和鲍曼不动杆菌对多重耐药检出率分别为9.6%和76.7%。结论我院腹腔标本分离病原菌以大肠埃希菌为代表的革兰阴性杆菌为主,肠球菌等革兰阳性菌所占比例有所增多。鲍曼不动杆菌检出率和耐药率呈上升趋势,应采取有效措施,控制耐药菌增长与传播。
[Abstract]:Objective to monitor the pathogen composition and drug resistance of abdominal cavity isolated samples in our hospital from 2013 to 2015, and to provide reference for the treatment of abdominal cavity infection. Methods the pathogenic bacteria were identified by VITEK 2 Compact system. The drug susceptibility tests were performed by disk method and MTS method. The results were analyzed by WHONET5.6 software. Results 1408 strains of pathogenic bacteria were isolated from 3610 abdominal cavity samples, and the positive rate of culture was 39.0%. Among them, 531 were Gram-negative bacteria (54.0%), 405 Gram-positive bacteria (41.2%), 46 fungi (4.7%), and the top 5 were Escherichia coli, Enterococcus faecium, Klebsiella pneumoniae, Enterococcus faecalis and Staphylococcus epidermidis. The resistance rates of Staphylococcus aureus and coagulase-negative staphylococcus to methicillin were 55.0% and 76.1%, respectively. There were no vancomycin resistant Staphylococcus aureus, teicoplanin and linazolamide resistant Staphylococcus aureus. The drug resistance rate of Enterococcus faecium was higher than that of Enterococcus faecalis. One strain of Enterococcus faecium was found to be resistant to vancomycin and linazolamide at the same time. Enterobacteriaceae bacteria were highly sensitive to carbapenes, amikacin and enzyme inhibitors. The ESBLs positive rates of Escherichia coli and Klebsiella pneumoniae were 56.3% and 29.1%, respectively. The detection rates of multidrug resistance of Pseudomonas aeruginosa and Acinetobacter baumannii were 9.6% and 76.7%, respectively. Conclusion Gram-negative bacilli represented by Escherichia coli were the main pathogens isolated from abdominal cavity in our hospital, and the proportion of Gram-positive bacteria such as Enterococcus was increased. The detection rate and drug resistance rate of Acinetobacter baumannii showed an increasing trend. Effective measures should be taken to control the growth and spread of resistant bacteria.
【作者单位】：天津医科大学总医院检验科;
【基金】：天津市应用基础与前沿技术研究计划项目(No.15JCYBJC26300)
【分类号】：R446.5

【相似文献】