胸腹水培养中的病原菌分布及耐药性分析

目的了解胸腹水培养中病原菌的分布和耐药情况,为临床合理用药提供依据。方法通过回顾性分析中山市第二人民医院住院部自2011年1月至2013年11月送检的胸腹水标本细菌培养及药敏资料。结果在494份胸腹水标本中共检出47株病原菌,总阳性率为9.5%;其中326例胸水分离出病原菌28例,阳性率为8.59%,胸水培养中革兰阳性菌占67.86%,革兰阴性菌占32.12%,菌种较为分散;168例腹水分离出病原菌19例,阳性率为11.31%,腹水培养中革兰阴性菌占73.68%,革兰阳性菌占26.32%。检出革兰阴性病原菌对氨苄西林和四环素耐药率较高,对阿米卡星、美罗培南和亚胺培南敏感。检出革兰阳性病原菌对氨苄西林、头孢西丁和红霉素耐药率高,对万古霉素、替考拉宁和吗啉噁酮敏感。结论应重视胸腹水标本的细菌学检查,依据药敏试验合理使用抗菌药物,减少细菌的耐药率。

Distribution and drug resistance of pathogens in hydrothorax and ascites

Objective To investigate the distribution and drug resistance of pathogenic bacteria in the pleural effusion and ascites, and provide the basis for clinical rational administration of drugs. Methods A retrospective analysis was performed on the the distribution and drug resistance of pathogenic bacteria in the pleural effusion and ascites from January 2011 to November 2013. Results 47 strains of pathogenic bacteria were detected in 494 pleural effusion and ascites specimens ; the overall positive rate was 9.50%. 28 strains of pathogenic bacteria were detected in 326 pleural effusion specimens （8.59%）, in which Gram positive bacteria accounted for 67.86%, while Gram negative bacteria accounted for 32.12%. 19 strains of pathogenic bacteria were detected in 168 aseites （ 11.31% ）, in which Gram negative bacteria accounted for 73.68% , while Gram positive bacteria accounted for 26.32%. The Gram negative pathogenic bacteria were more resistant to ampicillin and tetracycline, while sensitive to amikacin, meropenem and imipenem. The Gram positive bacteria were more resistant to ampicillin, cefoxitin and erythromycin, while sensitive to vancomycin, teicoplanin and linezolid. Conclusion We should pay attention to the bacteriological examination of pleural effusion and ascites, and use antimicrobial agents rationally on the basis of drug sensitivity test to reduce the bacterial drug resistance rate.