肝硬化患者并发自发性细菌性腹膜炎的病原菌及其药敏分析(1)
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[摘要]目的 探讨肝硬化患者并发自发性细菌性腹膜炎(SBP)患者的病原菌及其药敏分析。方法 回顾性分析130例肝硬化并发SBP患者腹水中分离出病原菌及其药敏学特点。结果 共培养出病原菌146株，其中G-菌103株，排在前三位的是大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌，G+菌34株和真菌9株。大肠埃希菌和肺炎克雷伯菌对亚胺培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率<35%。鲍曼不动杆菌对亚胺培南和头孢哌酮/舒巴坦的耐药率<40%。G+菌中以金黄色葡萄球菌和表皮葡萄球菌为主，耐药性严重，对万古霉素和替考拉宁的敏感率为100%。结论 SBP的病原菌仍以G-为主，由于病原菌多样性和耐药复杂性，临床上尽早进行腹水常规细菌培养和药敏试验，根据药敏结果早期合理地使用抗生素。
[关键词] 肝硬化；自发性细菌性腹膜炎；病原菌；药敏
[中图分类号] R657.3+1；R572.2 [文献标识码] B [文章编号] 1673-9701(2011)22- 120-02
The Pathogenic Bacteria and Its Drug Sensitivity of Cirrhosis Patient with Spontaneous Bacterial Peritonitis
QIAN Jianchu1 LAO Jinwei1 LUO Lifei2
1.Department of Emergency，the Second People’s Hospital of Tongxiang City in Zhejiang Province， Tongxiang 314511，China；2.Department of Clinical Laboratory， Taizhou Hospital in Zhejiang Province，Taizhou 318050，China
[Abstract] Objective To explore the pathogenic bacteria and its drug sensitivity of cirrhosis patient with spontaneous bacterial peritonitis(SBP). Methods Retrospectively analysis the drug sensitivity of pathogenic bacteria separated from the ascites of 130 cirrhosis patients with SBP. Results One hundred and forty-six strains of pathogenic bacteria were cultured. There were 103 strains of Gram-negative bacteria，and the top three were Escherichia coli， klebsiella pneumoniaeand Acineto bacter baumannii. There were 34 strains of Gram-positive bacteria and 9 strains of fungi. The rates of Escherichia coli and klebsiella pneumoniae resisting to imipenem，cefoperazone/sulbactam and piperacillin/tazobactam were all less than 35%.The rates of Acinetobacter baumannii resisting to imipenem and cefoperazone/sulbactam were both less than 40%.34 strains of Gram-negative bacteria were cultured，almost of which were staphylococcus aureus and Staphylococcus epidermidis，with severe drug resistant，but the sensitivity rate to vancomycin and Teicoplanin both were 100% ......
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