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Pathogenic bacteria in abdominal cavity drainage of patients with intraabdominal infection and their drug resistance
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- Author:
- No author available
- Journal Title:
- World Chinese Journal of Digestology
- Issue:
- 9
- DOI:
- 10.11569/wcjd.v26.i9.550
- Key Word:
- 腹腔感染;腹腔引流;细菌培养;多重耐药菌
Abstract： 目的 探究腹腔感染患者腹腔引流液中病原菌分布及其耐药性情况.方法 选择2015-01/2017-11天津市宁河区医院就诊并行腹腔引流术的腹腔感染患者92例进行回顾性分析,统计患者的腹腔引流液细菌培养和药敏结果,分析不同菌群和耐药性的差异,并应用Cox回归分析模型探究影响患者预后的独立危险因素.结果 共培养出菌株145例,其中革兰氏阳性菌44株、革兰氏阴性菌97株和真菌4株;大肠埃希菌(31.72％),肺炎克雷伯杆菌(24.14％),金黄色葡萄球菌(15.86％),肠球菌属(11.72％),铜绿假单胞菌(7.59％)的构成比较高.金黄色葡萄球菌和肠球菌属的耐药率较高,但均对万古霉素高度敏感;其中,肠球菌属对红霉素、氯霉素、左氧氟沙星的耐药率高于金黄色葡萄球菌,金黄色葡萄球菌对氨苄青霉素的耐药性较高.G-菌属均存在较高的耐药率,但均对β-内酰胺类/β-内酰胺酶(extended-spectrum β-1actamase,ESBLs)抑制剂、亚胺培南/西司他丁和阿米卡星具有较高的敏感性;其中,超广谱ESBLs+的菌属以及铜绿假单胞菌对头孢曲松、头孢他啶、头孢吡肟和左氧氟沙星的耐药率较高.多因素Cox回归分析显示,多重耐药菌(multi drug resistance bacteria,MDRO)、ESBLs+和发热至培养时间是腹腔感染患者死亡的独立危险因素.结论 腹腔感染患者腹腔引流液中病原菌分布以革兰氏阴性菌为主,且病原菌对常用抗菌素具有较高的耐药性,MDRO、ESBLs+和发热至培养时间是腹腔感染患者死亡的独立危险因素.
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