肝硬化失代偿患者腹水病原学分析

发布时间：2018-11-06 08:20

【摘要】：目的探讨肝硬化失代偿患者腹水的病原学特点以及对抗菌药物的敏感性,为临床治疗提供参考。方法选取2011年3月-2013年12月肝硬化失代偿合并院内不典型腹水自发性感染患者174例,采集患者腹水进行病原菌培养以及药物敏感试验,采用SPSS13.0软件对数据进行统计分析。结果 174例患者共检出病原菌182株,其中部分患者存在多重感染;检出革兰阴性菌94株占51.65%,革兰阳性菌79株占43.41%,真菌9株占4.94%;革兰阴性菌对呋喃妥因、阿米卡星以及头孢西丁表现出了较高的敏感性,分别达到95.74%、94.68%和92.55%,而对氨苄西林/舒巴坦敏感性较低,仅为45.74%;革兰阳性菌对万古霉素均敏感,达到100.00%,而普遍对红霉素敏感性较低,仅为58.23%。结论肝硬化失代偿患者腹水自发性感染的病原菌分布较广,部分患者可同时存在多种病原菌感染,应根据经验及时给予抗菌药物联合应用,待结果报告后及时对药物进行调整,以期控制、改善患者预后。
[Abstract]:Objective to investigate the etiological characteristics and antimicrobial sensitivity of ascites in patients with decompensated cirrhosis. Methods from March 2011 to December 2013, 174 patients with decompensated cirrhosis complicated with spontaneous infection of atypical ascites were collected for pathogen culture and drug sensitivity test. The data were statistically analyzed by SPSS13.0 software. Results 182 strains of pathogens were detected in 174 patients, some of them had multiple infections, 94 strains of Gram-negative bacteria accounted for 51.65%, 79 strains of Gram-positive bacteria accounted for 43.41%, 9 strains of fungi accounted for 4.94%. Gram-negative bacteria showed high sensitivity to furantoin, amikacin and cefoxitin, reaching 95.74% and 92.55%, respectively, while ampicillin / sulbactam was less sensitive to ampicillin / sulbactam (45.74%). Gram-positive bacteria were sensitive to vancomycin, reaching 100.00m, but generally less sensitive to erythromycin (58.23cm). Conclusion the pathogenic bacteria of ascites spontaneous infection in patients with decompensated liver cirrhosis are widely distributed, and some patients may have multiple pathogens at the same time. The combined use of antimicrobial agents should be given in time according to experience, and the drugs should be adjusted in time after the results are reported. In order to control and improve the prognosis of patients.
【作者单位】：平顶山市第一人民医院消化内科;
【基金】：河南省卫生厅重点扶持基金资助项目(HW-2012B-037)
【分类号】：R575.2

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