本文選題：重癥急性胰腺炎　切入點：感染　出處：《中華醫(yī)院感染學(xué)雜志》2016年15期

【摘要】：目的觀察和分析重癥急性胰腺炎(SAP)患者術(shù)后感染病原菌分布及耐藥性,為制定臨床治療方案提供客觀參考依據(jù)。方法選取2012年1月-2013年12月100例行引流手術(shù)且術(shù)后胰腺感染SAP患者作為研究對象,對其腹腔引流物病原菌分布及耐藥性進行檢測,數(shù)據(jù)采用WHONET 5.4軟件進行統(tǒng)計分析。結(jié)果共分離出321株病原菌,以革蘭陰性菌為主,共251株占78.2%;在革蘭陰性菌中,大腸埃希菌和肺炎克雷伯菌中分別檢出22株和13株產(chǎn)ESBLs菌,產(chǎn)ESBLs菌的總檢出率為10.9%;鮑氏不動桿菌和銅綠假單胞菌對多黏菌素B耐藥率低,均為0;在革蘭陽性菌中,屎腸球菌、金黃色葡萄球菌對替考拉寧、萬古霉素、利奈唑胺耐藥率低,均為0。結(jié)論 SAP術(shù)后胰腺感染的病原菌分布和耐藥性具有一定的特征,臨床醫(yī)師應(yīng)盡量選用敏感性抗菌藥物進行治療,以達到提高治療效果、改善患者預(yù)后。
[Abstract]:Objective to observe and analyze the distribution and drug resistance of pathogenic bacteria in patients with severe acute pancreatitis (SAP) after operation.Methods from January 2012 to December 2013, 100 patients with postoperative pancreatic infection with SAP were selected as study objects. The distribution of pathogens and drug resistance in peritoneal drainage were detected. The data were analyzed by WHONET 5.4 software.Results 321 strains of pathogenic bacteria were isolated, among which 251 strains were Gram-negative bacteria (78.2%), 22 strains of Escherichia coli and 13 strains of Klebsiella pneumoniae were found to produce ESBLs, respectively.The total detection rate of ESBLs producing bacteria was 10.9. The resistance rate of Acinetobacter baumannii and Pseudomonas aeruginosa to polymyxin B was 0. Among Gram-positive bacteria, Enterococcus faecium and Staphylococcus aureus were resistant to teicoplanin, vancomycin and linazolamine.0.Conclusion the distribution of pathogenic bacteria and drug resistance of pancreatic infection after SAP have certain characteristics. The clinicians should use sensitive antibiotics as far as possible in order to improve the therapeutic effect and improve the prognosis of the patients.
【作者單位】： 湖北民族學(xué)院附屬民大醫(yī)院急診外科;湖北民族學(xué)院附屬民大醫(yī)院普外科;湖北民族學(xué)院附屬民大醫(yī)院感染科;
【基金】：湖北省科技廳基金資助項目(EK2013D130003000113)
【分類號】：R657.51

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