摘要
目的分析乙型肝炎病毒(HBV)相关性终末期肝病(ESLD)并自发性腹膜炎(SBP)患者腹水标本细菌培养及药敏试验结果。方法选取平顶山市第二人民医院2020年5月至2021年7月收治的86例HBV相关性ESLD并SBP患者作为研究对象,收集其腹水标本,进行细菌培养和药敏试验,分析细菌分布特征及其耐药性。结果86份标本中共分离出80株菌株,包括47株(58.75%)革兰阴性菌(主要为大肠埃希菌)和33株(41.25%)革兰阳性菌(主要为表皮葡萄球菌)。革兰阴性菌对于青霉素类抗生素耐药性高,普遍超出60%,对于β-内酰胺酶抑制剂类抗生素耐药性低。在对头孢菌素类抗生素的耐药性方面,革兰阴性菌对第1代头孢菌素类抗生素耐药性最高,其次为第2代,最后为第3代。大肠埃希菌对于庆大霉素、头孢呋辛酯、头孢噻吩、替卡西林、哌拉西林、阿莫西林耐药性高。革兰阳性菌对于万古霉素、夫西地酸敏感,对于替考拉宁与呋喃妥因等抗生素耐药性低,对于诺氟沙星等抗生素耐药性高于替考拉宁。表皮葡萄球菌对于红霉素、苯唑西林、青霉素耐药性高,对于夫西地酸、米诺环素敏感。结论HBV相关性ESLD合并SBP患者腹水中主要为革兰阴性菌,其次为革兰阳性菌,不同菌株的耐药性存在差异,临床应结合细菌培养与药敏试验结果合理选用抗生素。
Objective To analyze the bacterial culture and drug sensitivity test results of ascites specimens from patients with hepatitis B virus(HBV)-related end-stage liver disease(ESLD)and spontaneous peritonitis(SBP).Methods Eighty-six patients with HBV-related ESLD and SBP admitted to Pingdingshan Second People’s Hospital from May 2020 to July 2021 were selected as the research objects.The ascites samples were collected for bacterial culture and drug sensitivity test,and the distribution characteristics and drug resistance of bacteria were analyzed.Results A total of 80 strains were isolated from 86 specimens,including 47(58.75%)gram-negative bacteria(mainly Escherichia coli)and 33(41.25%)gram-positive bacteria(mainly Staphylococcus epidermidis).Gram-negative bacteria had high resistance to penicillin antibiotics,generally exceeding 60%,and low resistance to β-lactamase inhibitor antibiotics.In terms of resistance to cephalosporins,gram-negative bacteria were the most resistant to the first generation of cephalosporins,followed by the second generation,and finally the third generation.Escherichia coli was highly resistant to gentamicin,cefuroxime axetil,cephalothin,ticarcillin,piperacillin,and amoxicillin.Gram-positive bacteria were sensitive to vancomycin and fusidic acid,had low resistance to antibiotics such as teicoplanin and nitrofurantoin,and were more resistant to norfloxacin than teicoplanin.Staphylococcus epidermidis was highly resistant to erythromycin,oxacillin,and penicillin,and was sensitive to fusidic acid and minocycline.Conclusion The bacteria in the ascites of patients with HBV-related ESLD and SBP are mainly Gram-negative bacteria,followed by Gram-positive bacteria.There are differences in the drug resistance of different strains,and antibiotics should be selected reasonably in combination with the results of bacterial culture and drug susceptibility tests.
作者
祁洪锋
胡世坤
QI Hongfeng;HU Shikun(Department of Laboratory Medicine,Pingdingshan Second People’s Hospital,Pingdingshan 467000,China)
出处
《河南医学研究》
CAS
2021年第31期5907-5910,共4页
Henan Medical Research
关键词
终末期肝病
自发性腹膜炎
细菌培养
药敏试验
抗生素
end-stage liver disease
spontaneous peritonitis
bacterial culture
drug sensitivity test
antibiotics
