外科理论与实践2017，Vol.22Issue(6)：515-519,5.DOI:10.16139/j.1007-9610.2017.06.013
阑尾腔和腹腔脓液细菌培养及药敏结果分析
Bacterial culture and drug sensitivity of appendiceal and peritoneal fluid in acute supprative appendicitis
姜笑明 1黄文海 1李小燕 1彭上晋 1俞建平1
作者信息
- 1. 复旦大学附属金山医院普外科,上海201508
- 折叠
摘要
Abstract
Objective To analyzed the bacterial species from culture and drug sensitivity of appendiceal and peritoneal fluid in the patients with acute suppurative appendicitis for rational use of antibiotics.Methods Both peritoneal fluid and appendiceal exudates in 100 patients with acute suppurative appendicitis between 2014 and 2015 (study group) were collected.Bacterial culture and drug sensitivity were performed to analyze the main pathogens.The results of bacterial culture and the treatment in study group were compared to 408 patients in 2013 as control group.Results A total of 200 samples from both peritoneal cavity and appendix in study group were tested and 113 strains of bacteria were isolated.The major two bacteria were Escherichia coli 83 strains (73.5％) and Pseudomonas aeruginosa 14 strains (12.4％).Extended-spectrum β-laetamase (ESBL) producing strains of Escherichia coli from study group were detected in 45 strains (54.2％),which was significantly higher than from control group (5 strains,31.3％,P=0.013).The antibiotics with higher sensitivity to ESBL-producing Escherichia coli were imipenem (100％),amikacin (95.6％),cefmetazole (84.5％),cefoperazone/sulbactam (82.2％) and piperacillin-tazobactam (73.3％) with resistance ≤ 17.8％.The higher resistance to ESBL-producing Escherichia coli were piperacillin (95.6％),cefazolin (100％),cefaclor (100％),cefuroxime (93.3％),cefotaxime (91.1％),gentamicin (77.8％) and sulfamethoxazole compound (84.5％).The duration of antibiotic therapy [(1.4±1.3) d vs (2.6±0.8) d,P＜0.001] and hospital stay [(3.5±2.1) d vs (4.3±2.4) d,P=0.004] in study group were significantly shorter than those in control group.There was no difference of wound infection rate (2.0％ vs 3.2％,P=0.746).Conclusions The main pathogens in the patients with acute appendicitis are Escherichia coli.The ESBL-producing Escherichia coli were found rising trend and resistant to the broad-spectrum penicillins and cephalosporins.The first choice of antibiotic in the treatment of acute suppurative appendicitis infected by ESBL-producing Escherichia coli were cefoperazone/sulbactam,cefmetazole and piperacillin-tazobactam.关键词
阑尾炎/细菌培养/药敏试验/抗生素Key words
Appendicitis/Bacterial culture/Susceptibility testing/Antibiotic分类
医药卫生引用本文复制引用
姜笑明,黄文海,李小燕,彭上晋,俞建平..阑尾腔和腹腔脓液细菌培养及药敏结果分析[J].外科理论与实践,2017,22(6):515-519,5.
