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  • 王慧,黄玉凤,高兰兰,方莎莎,凌水花,张国庆*.细菌性肝脓肿病原菌检测及抗菌药物使用分析[J].第二军医大学学报,2019,40(6):688-692    [点击复制]
  • WANG Hui,HUANG Yu-feng,GAO Lan-lan,FANG Sha-sha,LING Shui-hua,ZHANG Guo-qing*.Detection of pathogenic bacteria in bacterial liver abscess and the utilization of antibiotics[J].Acad J Sec Mil Med Univ,2019,40(6):688-692   [点击复制]
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细菌性肝脓肿病原菌检测及抗菌药物使用分析
王慧,黄玉凤,高兰兰,方莎莎,凌水花,张国庆*
0
(海军军医大学(第二军医大学)东方肝胆外科医院药材科, 上海 200438
*通信作者)
摘要:
目的 探讨细菌性肝脓肿病原学分布、抗菌药物的敏感性特点及使用情况。方法 对我院安亭院区2015年10月至2017年4月收治的125例细菌性肝脓肿患者的临床资料进行分析,调研细菌培养结果及耐药情况,分析抗菌药物的使用情况。结果 94例患者行病原菌检查,其中51例患者的62个样本细菌培养阳性。共检出62株细菌,其中革兰阴性菌53株(85.48%),主要为肺炎克雷伯菌(33株)、大肠埃希菌(10株);革兰阳性菌9株(14.52%),主要为金黄色葡萄球菌(2株)、屎肠球菌(2株)和粪球肠菌(2株)。肺炎克雷伯菌和大肠埃希菌中产超广谱β-内酰胺酶菌分别占6.06%(2/33)和60.0%(6/10)。头孢曲松钠、头孢哌酮/舒巴坦钠、亚胺培南/西司他丁钠用药频度较大且药物利用指数>1。结论 细菌性肝脓肿主要致病菌为革兰阴性菌,其中以肺炎克雷伯菌和大肠埃希菌为主。为减少耐药菌的产生,应加强抗菌药物使用的管理,尽早明确病原菌,并根据药物敏感试验结果选用抗菌药物。
关键词:  细菌性肝脓肿  肺炎克雷伯菌  细菌抗药性  药物利用
DOI:10.16781/j.0258-879x.2019.06.0688
投稿时间:2018-10-09修订日期:2019-02-09
基金项目:
Detection of pathogenic bacteria in bacterial liver abscess and the utilization of antibiotics
WANG Hui,HUANG Yu-feng,GAO Lan-lan,FANG Sha-sha,LING Shui-hua,ZHANG Guo-qing*
(Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Naval Medical University(Second Military Medical University), Shanghai 200438, China
*Corresponding author)
Abstract:
Objective To investigate the pathogenic bacterium distribution in bacterial liver abscess and sensitivity characteristics and utilization of antibiotics. Methods The clinical data of 125 patients with bacterial liver abscess, who were admitted to anting branch of our hospital from Oct. 2015 to Apr. 2017, were collected and analyzed retrospectively. The results of bacterial culture, drug resistance and use of antibiotics were investigated. Results Totally 94 patients were examined for pathogens, and 62 samples from 51 patients were positive to bacterial culture. A total of 62 strains of bacteria were detected, including 53 (85.48%) strains of Gram-negative bacteria, of which the most common bacteria were Klebsiella pneumoniae (33 strains) and Escherichia coli (10 strains), and 9 (14.52%) strains of Gram-positive bacteria, of which Staphylococcus aureus, Enterococcus faecium, and Enterococcus faecalis were rather common (2 strains in each). Extended-spectrum β-lactamase (ESBL)-producing strains accounted for 6.06% (2/33) and 60.0% (6/10) in Klebsiella pneumonia and Escherichia coli, respectively. Ceftriaxone sodium, cefoperazone/sulbactam sodium, and imipenem/cilastatin sodium had higher defined daily dose system resulting in drug utilization index >1. Conclusion The most common pathogens causing bacterial liver abscess are Gram-negative bacteria, mainly Klebsiella pneumoniae and Escherichia coli. Clinically, we should strengthen the management of antibiotics use, identify the pathogens as soon as possible, and select optimum drugs based on drug-susceptibility test results to reduce drug resistance rate.
Key words:  bacterial liver abscess  Klebsiella pneumoniae  bacterial drug resistance  drug utilization