重症急性胰腺炎继发感染的病原菌分布及临床特点分析

发布时间：2018-01-12 14:26

  本文关键词：重症急性胰腺炎继发感染的病原菌分布及临床特点分析　出处：《实用医学杂志》2017年22期 　论文类型：期刊论文

  更多相关文章： 重症急性胰腺炎 感染 病原菌 耐药性

【摘要】：目的探讨重症急性胰腺炎(SAP)继发感染的病原菌分布及临床特点。方法收集我院确诊SAP继发感染患者的临床资料,分析标本来源、病原菌分布及常用抗菌药物的耐药性。结果 (1)标本来源:培养阳性标本共156例,以痰液标本最多(46.79%);送检血液标本1周以内最多(70.59%),痰液标本1~2周最多(64.38%),胰腺坏死组织或胰周积液标本3周以后最多(51.79%),差异有统计学意义。(2)病原菌:分离培养出菌株156株,革兰阴性菌86株(55.13%),以鲍曼溶血不动杆菌和大肠埃希菌最常见,革兰阳性菌41株(26.28%),真菌29株(18.59%)。(3)耐药性:常见病原菌对常用抗生素耐药率高,鲍曼溶血不动杆菌对碳青霉烯类抗生素的耐药率达88.00%。结论 SAP继发感染的病原菌以革兰阴性菌为主,多重耐药菌的比例高,根据细菌培养选择合适的抗菌药物有利于早期控制感染。
[Abstract]:Objective to investigate the distribution and clinical characteristics of pathogenic bacteria in patients with secondary infection of severe acute pancreatitis (SAP). Methods the clinical data of patients with SAP secondary infection were collected and the source of specimens was analyzed. The distribution of pathogenic bacteria and drug resistance of common antimicrobial agents. Results: 156 positive specimens were cultured, and the sputum samples were 46.79%. The blood samples were collected within 1 week, the sputum samples were up to 64.38 and the pancreatic necrotic tissues or peripancreatic effusion samples were up to 51.79 after 3 weeks). The results showed that 156 strains were isolated and 86 strains were Gram-negative bacteria, among which Acinetobacter baumannii and Escherichia coli were the most common. The drug resistance of 41 Gram-positive bacteria and 29 fungi were 26.28 and 18.599.The resistance rate of common pathogens to common antibiotics was high. The resistance rate of Acinetobacter baumannii to carbapenem antibiotics was 88.00.Conclusion Gram-negative bacteria are the main pathogens of SAP secondary infection, and the proportion of multidrug resistant bacteria is high. The selection of appropriate antimicrobial agents based on bacterial culture is beneficial to the early control of infection.
【作者单位】： 西南医科大学附属医院消化内科;西南医科大学附属医院营养科;
【基金】：国家自然科学基金委员会-青年科学基金项目(编号:81600420)
【分类号】：R446.5;R576
【正文快照】： 重症急性胰腺炎(severe acute pancreatitis,SAP)病情凶险,病死率高,继发感染时病死率达29.5%~32.0%[1-2]。胰腺感染和胰腺外感染如肺炎、脓毒血症等均是SAP死亡的主要因素[3]。早期有效控制感染是降低SAP病死率的关键。然而近年来,多重耐药菌感染、多部位感染、二重感染等问，

本文编号：1414647