摘要
目的分析小儿肛周和阑尾脓肿标本分离病原菌构成及其主要病原菌的耐药性和耐药表型。方法收集2019年至2020年儿外科住院患者肛周和阑尾脓肿培养阳性的非重复标本。菌株鉴定应用质谱仪,药敏试验采用Vitek 2 Compact全自动微生物药敏仪,纸片扩散法(K-B法)作为药敏试验的补充。应用WHONET5.6软件和卡方检验进行数据分析。结果小儿肛周和阑尾脓肿共收集非重复分离病原菌分别为112株和132株。肛周脓肿分离革兰氏阳性菌30株(26.8%),革兰氏阴性菌82株(73.2%);阑尾脓肿分离革兰氏阳性菌12株(9.1%),革兰氏阴性菌120株(90.9%)。肛周脓肿分离主要病原菌为肺炎克雷伯菌、大肠埃希菌和金黄色葡萄球菌;阑尾脓肿分离主要病原菌为大肠埃希菌和铜绿假单胞菌。肛周脓肿分离肺炎克雷伯菌和大肠埃希菌ESBLs检出率占各自菌种的5.3%(2/38)、41.7%(15/36),金黄色葡萄球菌β-内酰胺酶检出率为100%(28/28),未检出耐甲氧西林金黄色葡萄球菌(MRSA);阑尾脓肿分离大肠埃希菌ESBLs检出率为54.1%(42/78),耐碳青霉烯类肠杆菌科细菌(CRE)检出率为1.3%(1/78),铜绿假单胞菌(26株)均为敏感菌株。结论小儿肛周和阑尾脓肿分离病原菌以革兰氏阴性菌为主,菌种类型不一,对抗菌药物的耐药程度不同,临床医师应重视病原学检测,并根据药敏试验结果选择抗菌药物,以减少耐药菌的产生。
Objective To analyze the composition of pathogenic bacteria isolated from perianal and appendiceal abscesses in children and the drug resistance and drug resistance phenotype of the main pathogenic bacteria.Methods Non-repetitive specimens with positive perianal and appendiceal abscess culture were collected from inpatients in the pediatric surgery department from 2019 to 2020.Strains were identified by mass spectrometer.Vitek 2 Compact automatic microbial drug sensitivity instrument was adopted for the drug sensitivity test and disk diffusion method(K-B method)was used as a supplement.WHONET5.6 software and chi-square test were used for data analysis.Results Totally 112 strains and 132 strains were isolated non-repetitively from perianal and appendiceal abscesses in children,including 30 strains(26.8%)of gram positive bacteria and 82 strains(73.2%)of gram negative bacteria isolated from perianal abscesses,and 12 strains(9.1%)of gram positive bacteria and 120 strains(90.9%)of gram negative bacteria isolated from appendiceal abscesses.The main pathogens isolated from perianal abscess were Klebsiella pneumonia,Escherichia coli and Staphylococcus aureus,while Escherichia coli and Pseudomonas aeruginosa were the main pathogens isolated from appendiceal abscess.ESBLs of Klebsiella pneumoniae and Escherichia coli,which isolated from perianal abscess,accounted for 5.3%and 41.7%respectively,while the rate ofβ-lactamase in Staphylococcus aureus was 100%and methicillin-resistant Staphylococcus aureus was not detected;the ESBLs of Escherichia coli isolated from appendiceal abscess was 54.1%,and the detection rate of CRE was 1.3%.Twenty-six strains of Pseudomonas aeruginosa were all sensitive strains.Conclusion Gram negative bacteria were the main pathogenic bacteria isolated from perianal and appendiceal abscesses in children,with a variety of bacteria,and the antimicrobial resistance was different.Clinicians should pay attention to the detection of etiology,and antibiotic agents should be selected reasonably according to the results of drug susceptibility tests in order to reduce the production of drug-resistant bacteria.
作者
王凤霞
满玉清
安新业
李娜
纪冰
WANG Fengxia;MAN Yuqing;AN Xinye;LI Na;JI Bing(Department of Clinical Laboratory,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;Department of Pharmacy,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China)
出处
《滨州医学院学报》
2022年第3期198-201,共4页
Journal of Binzhou Medical University
基金
滨州医学院科技计划(BY2017KJ18)
山东省医药卫生科技发展计划(2017WS801)。
关键词
肛周脓肿
阑尾脓肿
病原菌
耐药表型
敏感性
perianal abscess
appendiceal abscess
pathogen
drug resistance phenotype
susceptibility
