摘要
目的了解引起女性盆腔炎感染的病原菌分布及耐药情况,为临床正确诊断、合理应用抗菌药物提供科学依据。方法对分离的348株病原菌用K-B法进行药敏试验,对革兰阴性菌采用ESBLs确认试验检测ESBLs,头孢西丁三维试验检测AmpC酶。结果分离的348株病原菌中,革兰阴性菌215株,占61.78%,主要为大肠埃希菌、肺炎克雷伯菌、褪色沙雷菌;革兰阳性菌127株,占36.49%,以凝固酶阴性葡萄球菌、金黄色葡萄球菌居前2位,革兰阴性杆菌ESBLs、AmpC酶总检出率分别为38.1%、34.9%,单产ESBLs、单产AmpC、同产ESBLs+高产AmpC酶、ESBLs+诱导AmpC酶菌株依次占13.02%、9.77%、13.95%、11.16%;革兰阳性菌除对万古霉素、替考拉宁、喹奴普汀/达福普汀、利福平的耐药率较低外,其余抗菌药物的耐药率均>48.00%,革兰阴性菌对亚胺培南、美罗培南、头孢吡肟的耐药率分别为5.58%、3.72%、26.00%,产酶株较非产酶株具有较高的耐药率(P<0.05)。结论女性盆腔感染以凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、褪色沙雷菌为主,万古霉素、替考拉宁对革兰阳性菌,亚胺培南、美罗培南、头孢吡肟对革兰阴性菌具有良好的抗菌活性。
OBJECTIVE To understand the pathogen distribution and drug resistance of pelvic inflammatory disease in women,then help the clinic to use drug rationally. METHODS Totally 342 bacteria were isolated from the cervical or pelvic secretion and given in vitro drug sensitivity test with Kirby-Bauer method. ESBLs detected by ESBLs affirm test and AmpC detected by cefoxitin three dimensional test in G^- bacteria. RESULTS From the 342 strains isolated from this group, there were 215 G^-（62.9%）, the primary pathogenic bacteria were Escherichia coli, Klebsiella pneumoniae and Serratia marcescens, at the same time, there were 127 G^＋ （37.1%）, the most common pathogens were coagulase-negative staphylococci （CNS） and Staphylococcus aureus. The detectable rate of ESBLs and AmpC together were 38.1% and 34.9% in G^- , that of only ESBLs occupied 13.0%, that of only AmpC was 9.8%, that of ESBLs combined with high yield AmpC occupied 13.9%, and that of ESBLs combined with induced AmpC occupied 11.2%. Otherwise,the resistance rate to antibiotics was all higher than 48% except VAN, TEC, QDA and rifampin in G^＋. The rate of resistance to IPM, MEM and FEP were 5.58% ,3.72% ,and 26.0 % respectively in G^- ,and the drug resistance rate of enzyme-prodncing G^- were much more than that without enzyme-producing （P〈0.05）. CONCLUSIONS Basically, pathogenic bacteria which caused infection are CNS, S. aureus, E. coli, K. pneumoniae, and S. marcescens, the better antibiotics are VAN and TEC to G^＋ , IPM, and MEM and FEP to G^-.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第13期1747-1750,共4页
Chinese Journal of Nosocomiology
关键词
盆腔炎
细菌分布
耐药性
Pelvic inflammatory disease
Distribution of bacteria, Drug resistance
作者简介
通讯作者：温建艳，E-mail：zqtlm@yahoo．com．cn.
