老年需氧菌性阴道炎混合感染病原菌分布与耐药性监测

发布时间：2018-09-15 06:29

【摘要】：目的探讨老年需氧菌性阴道炎及混合感染的病原菌分布及其耐药性,为临床治疗提供参考。方法选取2011年1月-2013年12月老年需氧菌性阴道炎患者194例,年龄60~71岁;取其阴道侧壁及宫颈处分泌物进行病原菌培养,对于感染患者行菌株鉴定及药敏试验。结果 194例老年需氧菌阴道炎患者中以单纯需氧菌性阴道炎为主,占70.10%,其次是合并细菌性阴道炎及合并阴道毛滴虫感染,分别占13.92%和11.34%,白色假丝酵母菌性阴道炎最少,仅占4.64%;194例患者共检出病原菌207株,其中需氧菌183株、厌氧菌24株,需氧菌中以链球菌属最为常见,76株占36.71%,其次是葡萄球菌属和大肠埃希菌,分别占21.26%和14.98%,在所有病原菌中除大肠埃希菌外均为革兰阳性菌;革兰阳性菌对庆大霉素、青霉素、红霉素的耐药率较高,分别为56.25%、50.57%和50.00%,对万古霉素的耐药率为0,对利奈唑胺和氨苄西林的耐药率较低,仅为1.14%和9.66%;大肠埃希菌对氨苄西林耐药率较高,为87.10%,而对头孢哌酮/舒巴坦及亚胺培南的耐药率为0。结论引起感染的病原菌中无论是需氧菌还是厌氧菌均以革兰阳性菌为主,而革兰阴性菌较少;在治疗时应尽量选择耐药性较低的敏感抗菌药物,在病原菌不明时,可同时辅以头孢哌酮/舒巴坦或亚胺培南。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in elderly patients with aerobic vaginitis and mixed infections, and to provide reference for clinical treatment. Methods 194 elderly patients with aerobic vaginitis, aged 60 ~ 71 years, were selected from January 2011 to December 2013. The vaginal lateral wall and cervical secretions were collected for pathogen culture, and strain identification and drug sensitivity test were performed for the infected patients. Results among 194 elderly patients with aerobic vaginitis, only aerobic vaginitis accounted for 70.10%, followed by bacterial vaginitis and trichomonas vaginalis infection, accounting for 13.92% and 11.34%, respectively. Candida albicans vaginitis were the least. 207 strains of pathogenic bacteria were detected in 194 patients, including 183 strains of aerobic bacteria and 24 strains of anaerobes. Among the aerobic bacteria, 76 strains of Streptococcus were the most common, followed by Staphylococcus and Escherichia coli. In addition to Escherichia coli, Gram-positive bacteria were found to be Gram-positive, and Gram-positive bacteria were resistant to gentamicin, penicillin and erythromycin, respectively, and the resistance rate of Gram-positive bacteria to gentamicin, penicillin and erythromycin was higher. The resistance rate to vancomycin was 0, the resistance rate to linazolamine and ampicillin was 1.14% and 9.66 respectively, the resistance rate of Escherichia coli to ampicillin was higher. The resistance rate to cefoperazone / sulbactam and imipenem was 0. Conclusion Gram-positive bacteria and gram-negative bacteria are the main pathogens causing infection, and sensitive antimicrobial agents with low resistance should be selected when the pathogens are unknown. Cefoperazone / sulbactam or imipenem may be added at the same time.
【作者单位】：聊城市中医院妇产科;
【基金】：山东省卫生厅重点扶持基金资助项目(SW-2009A010104)
【分类号】：R711.31

【参考文献】