摘要
目的研究肝硬化患者血流感染的病原学特征及其耐药性,为临床合理选用抗菌药物提供参考。方法通过回顾性调查方法,对某医院肝硬化患者合并血流感染患者的临床送检标本检验资料进行调查与分析。结果调查期间该医院共发现肝硬化合并血流感染患者188例,从这些患者送检标本中,共分离出病原菌204株,其中革兰阴性菌占66.67%,革兰阳性菌占30.39%,真菌占2.94%。引起肝硬化患者血流感染的优势菌居前四位是大肠埃希菌、肺炎克雷伯菌、葡萄糖非发酵菌和肠球菌,构成比依次是26.47%、20.59%、13.73%和10.78%。药敏试验筛选出产超广谱β-内酰胺酶(ESBLs)肠杆菌比例为38.89%,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)所占比例分别为33.33%和38.46%,未发现耐药万古霉素菌株。结论引起肝硬化患者血流感染的病原菌以革兰阴性菌多见,也有真菌感染,应特别加强监控和抗菌药物管理。
Objective To study the characteristics of etiology of bloodstream infections and drug resistance of pathogens in patients with cirrhosis so as to provide reference for clinical rational use of antimicrobial drugs. Methods By the meth- od of retrospective survey, the test data of clinical samples from the cirrhotic patients with bloodstream infections in hospital were investigated and analyzed. Results 188 cases of patients with cirrhosis combined blood stream infections were found in this hospital during the survey period. From the samples of these patients, 204 strains pathogenic bacteria were isolated and the gram negative bacteria accounted for 66. 67%, the gram - positive bacteria accounted for 30. 39% and the fungus accounted for 2.94%. The top four advantage bacterium of patients with cirrhosis bloodstream infections were Escherichia coli, Klebsiella pneumoniae, glucose fermentation bacteria and enterococcus, and the constituent ratio were 26. 47%, 20. 59%, 13.73% and 20. 59% respectively. The Escherichia coli producing ultra broad spectrum beta lactamase （ ES- BLs）, methicillin- resistant Staphylococcus aureus （MRSA） and methicillin- resistant coagulase negative Staphylococcus （MRCNS） were 38.89%, 33.33% and 38. 46% respectively screened with the drug sensitive test. There was no vanco- mycin resistant strain found. Conclusion The pathogens that causing bloodstream infections of liver cirrhosis patients is mainly the gram- negative bacteria, and the fungus is not isolated. Monitoring and antibacterial drugs management should be particularly strengthened.
出处
《中国消毒学杂志》
CAS
北大核心
2014年第4期366-369,共4页
Chinese Journal of Disinfection
关键词
肝硬化患者
血流感染
病原菌
耐药性
patients with cirrhosis
bloodstream infections
pathogenic bacteria
drug resistance
