本文關(guān)鍵詞：重癥急性胰腺炎繼發(fā)感染的病原菌分布及臨床特點(diǎn)分析　出處：《實(shí)用醫(yī)學(xué)雜志》2017年22期 　論文類(lèi)型：期刊論文

  更多相關(guān)文章： 重癥急性胰腺炎 感染 病原菌 耐藥性

【摘要】：目的探討重癥急性胰腺炎(SAP)繼發(fā)感染的病原菌分布及臨床特點(diǎn)。方法收集我院確診SAP繼發(fā)感染患者的臨床資料,分析標(biāo)本來(lái)源、病原菌分布及常用抗菌藥物的耐藥性。結(jié)果 (1)標(biāo)本來(lái)源:培養(yǎng)陽(yáng)性標(biāo)本共156例,以痰液標(biāo)本最多(46.79%);送檢血液標(biāo)本1周以?xún)?nèi)最多(70.59%),痰液標(biāo)本1~2周最多(64.38%),胰腺壞死組織或胰周積液標(biāo)本3周以后最多(51.79%),差異有統(tǒng)計(jì)學(xué)意義。(2)病原菌:分離培養(yǎng)出菌株156株,革蘭陰性菌86株(55.13%),以鮑曼溶血不動(dòng)桿菌和大腸埃希菌最常見(jiàn),革蘭陽(yáng)性菌41株(26.28%),真菌29株(18.59%)。(3)耐藥性:常見(jiàn)病原菌對(duì)常用抗生素耐藥率高,鮑曼溶血不動(dòng)桿菌對(duì)碳青霉烯類(lèi)抗生素的耐藥率達(dá)88.00%。結(jié)論 SAP繼發(fā)感染的病原菌以革蘭陰性菌為主,多重耐藥菌的比例高,根據(jù)細(xì)菌培養(yǎng)選擇合適的抗菌藥物有利于早期控制感染。
[Abstract]:Objective to investigate the distribution and clinical characteristics of pathogenic bacteria in patients with secondary infection of severe acute pancreatitis (SAP). Methods the clinical data of patients with SAP secondary infection were collected and the source of specimens was analyzed. The distribution of pathogenic bacteria and drug resistance of common antimicrobial agents. Results: 156 positive specimens were cultured, and the sputum samples were 46.79%. The blood samples were collected within 1 week, the sputum samples were up to 64.38 and the pancreatic necrotic tissues or peripancreatic effusion samples were up to 51.79 after 3 weeks). The results showed that 156 strains were isolated and 86 strains were Gram-negative bacteria, among which Acinetobacter baumannii and Escherichia coli were the most common. The drug resistance of 41 Gram-positive bacteria and 29 fungi were 26.28 and 18.599.The resistance rate of common pathogens to common antibiotics was high. The resistance rate of Acinetobacter baumannii to carbapenem antibiotics was 88.00.Conclusion Gram-negative bacteria are the main pathogens of SAP secondary infection, and the proportion of multidrug resistant bacteria is high. The selection of appropriate antimicrobial agents based on bacterial culture is beneficial to the early control of infection.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院消化內(nèi)科;西南醫(yī)科大學(xué)附屬醫(yī)院營(yíng)養(yǎng)科;
【基金】：國(guó)家自然科學(xué)基金委員會(huì)-青年科學(xué)基金項(xiàng)目(編號(hào):81600420)
【分類(lèi)號(hào)】：R446.5;R576
【正文快照】： 重癥急性胰腺炎(severe acute pancreatitis,SAP)病情兇險(xiǎn),病死率高,繼發(fā)感染時(shí)病死率達(dá)29.5%~32.0%[1-2]。胰腺感染和胰腺外感染如肺炎、膿毒血癥等均是SAP死亡的主要因素[3]。早期有效控制感染是降低SAP病死率的關(guān)鍵。然而近年來(lái),多重耐藥菌感染、多部位感染、二重感染等問(wèn)，

本文編號(hào)：1414647