细菌性肝脓肿病原学分布及耐药性分析

发布时间：2018-06-16 16:13

本文选题：细菌性肝脓肿 + 致病菌　；参考：《西部医学》2017年05期

【摘要】：目的探讨细菌性肝脓肿的病原菌分布,为临床经验性选择抗菌药物提供依据。方法回顾性分析重庆医科大学附属第一医院于2013年1月~2015年12月收治的68例细菌性肝脓肿患者主要临床表现、基础疾病、降钙素原检查结果、病原学检查细菌分布及药敏试验结果、临床治疗方案选择。结果脓液和血标本中共分离培养出94株细菌,其中革兰阴性菌78株,以肺炎克雷伯杆菌(57株)为主,其次为大肠埃希菌(15株);革兰阳性菌16株,主要为星座链球菌(4株),咽峡炎链球菌、中间链球菌、溶血葡萄球菌、屎肠球菌(D群)各2株。药敏试验结果显示针对革兰阴性菌厄他培南、亚胺培南西司他丁、替加环素、头孢替坦、头孢吡肟、头孢他啶、头孢西丁、阿米卡星、哌拉西林他唑巴坦敏感度均90%;对于革兰阳性菌,替加环素、万古霉素、奎努普汀/达福普汀敏感度90%。对于伴随疾病,肺炎克雷伯杆菌肝脓肿好发于糖尿病患者,而非肺炎克雷伯菌肝脓肿好发于存在胆道疾病基础的患者。结论细菌性肝脓肿致病菌主要为肺炎克雷伯杆菌,好发于糖尿病患者,其对喹诺酮类、氨基糖苷类、β-内酰胺类、碳青霉烯类抗菌药物敏感度较高。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria of bacterial liver abscess in order to provide the basis for clinical empirical selection of antibiotics. Methods the main clinical manifestations, basic diseases, calcitonin test results and pathogenic bacteria examination of 68 patients with bacterial liver abscess treated in First Affiliated Hospital of Chongqing Medical University in January 2013, ~2015, in December, were analyzed retrospectively. Results 94 strains of bacteria were isolated and cultured in pus and blood samples, including 78 Gram-negative bacteria, 57 strains of Klebsiella pneumoniae (57 strains), followed by Escherichia coli (15), and 16 Gram-positive bacteria (4 strains), Streptococcus angina, Streptococcus intermedius, dissolution. 2 strains of Staphylococcus aureus and Enterococcus faecium (group D). The results of drug sensitivity test showed that the gram-negative bacilli, imipenem, tigatin, ceftiettan, cefimoxime, ceftazidime, cefoxitin, cefoxitin, Amikacin, piperacillin and tazobactam were sensitive to 90%, and Gram-positive bacteria, tetracycline, vancomycin, Kui Nu 90%. sensitivity 90%. for the associated disease, Klebsiella pneumoniae liver abscess in diabetic patients, and not Klebsiella pneumoniae liver abscess in the base of the existence of biliary disease. Conclusion bacterial liver abscess is mainly caused by Klebsiella pneumoniae, good hair in diabetic patients, quinolones, amino sugar Glucosides, beta lactam, carbapenem antibiotics are highly sensitive.
【作者单位】：重庆医科大学附属第一医院感染科·重庆市传染病寄生虫病学重点实验室;
【基金】：人事部科研基金(09958013) 重庆市自然科学基金(CSTC2009BB5061)
【分类号】：R575.4

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