河北医科大学学报

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妊娠合并急性阑尾炎病原菌分布及抗生素选用#br#

  

  1. 1.河北中石油中心医院检验科,河北 廊坊 065000;2.河北省廊坊市人民医院普外科,河北 廊坊 065000
  • 出版日期:2020-09-25 发布日期:2020-09-27
  • 作者简介:孙岩(1981-),女,河北廊坊人,河北中石油中心医院主管技师,医学学士,从事医学检验研究。

Distribution of pathogenic bacteria and antibiotics application in patients with acute appendicitis during pregnancy

  1. 1.Department of Clinical Laboratory, Hebei Petro China Central Hospital, Langfang 065000, China;
    2.Department of General Surgery, Langfang People′s Hospital, Hebei Province, Langfang 065000, China
  • Online:2020-09-25 Published:2020-09-27

摘要: 目的  〖KG*2〗探讨妊娠合并急性阑尾炎患者局部脓液的病原菌需氧培养结果及其对抗生素的敏感性,为临床治疗提供依据。
〖HTH〗方法  〖KG*2〗选取妊娠合并急性阑尾炎患者164例为研究对象,采集脓液标本,进行病原菌培养和药敏分析。
〖HTH〗结果  〖KG*2〗164例标本中有102份标本培养共检出106株病原菌。其中革兰阴性菌占93.40%,主要包括大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌,分别占66.98%、9.43%、7.55%。药敏分析显示大肠埃希菌株对美罗培南、亚胺培南、头孢西丁、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、替卡西林/克拉维酸、阿莫西林/克拉维酸敏感,敏感率均≥85.00%;肺炎克雷伯菌对美罗培南、亚胺培南、头孢西丁、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、头孢吡肟、头孢哌酮/舒巴坦、替卡西林/克拉维酸敏感,敏感率均≥90.00%;铜绿假单胞菌对美罗培南、亚胺培南、头孢西丁、头孢吡肟、哌拉西林/他唑巴坦、替卡西林/克拉维酸、阿莫西林/克拉维酸、头孢他啶、头孢哌酮/舒巴坦敏感,敏感性均≥85.00%。3种主要致病菌最敏感的抗生素是美罗培南和亚胺培南,有效率达到100.00%。3种主要致病菌敏感性≥85.00%的是头孢西丁、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、替卡西林/克拉维酸和阿莫西林/克拉维酸。
〖HTH〗结论  〖KG*2〗妊娠合并急性阑尾炎患者的感染以革兰阴性菌为主,美罗培南和亚胺培南可作为主要抗生素备选,其他疗效较好的药物还包括头孢西丁、哌拉西林、头孢哌酮等。临床上应结合妊娠用药特点合理选择相应的抗菌药物。

关键词: 妊娠, 急性阑尾炎, 病原菌

Abstract: Objective  To investigate the results of bacterial culture of pus as well as antibiotic sensitivity in patients with acute appendicitis during pregnancy and to provide basis for future clinical treatment.
  Methods  We selected 164 cases of pregnant patients with acute appendicitis as research objects. The pathogen culture and drug sensitivity analysis of pus samples were conducted.
  Results  A total of 106 pathogenic bacteria were detected in 102 specimens of 164 samples. Gram-negative bacteria accounted for 93.40%, mainly including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, accounting for 66.98%, 9.43% and 7.55% respectively. Drug sensitivity analysis showed that Escherichia coli were sensitive to meropenem, imipenem, cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanic acid and amoxicillin/clavulanic acid. The sensitivity rate was≥85.00%; while Klebsiella pneumoniae was sensitive to meropenem, imipenem, cefoxitin, piperacillin/tazobactam, amoxicillin/clavulanic acid, cefepime, cefoperazone/sulbactam, ticarcillin/clavulanic acid. The sensitivity rate was≥90.00%, and Pseudomonas aeruginosa was sensitive to meropenem, imipenem, cefoxitin, cefepime, piperacillin/tazobactam, ticarcillin/clavulanic acid, amoxicillin/clavulanic acid, ceftazidime and cefoperazone/sulbactam. The sensitivity rate was≥85.00%. The sensitivity was greater than or equal to 85.00%. The most sensitive antibiotics of the three main pathogenic bacteria were meropenem and imipenem, with an effective rate of 100.00%. Cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanic acid and amoxicillin/clavulanic acid were more than 85.00% sensitive.
  Conclusion  Gram-negative bacteria are the main infections in patients with acute appendicitis during pregnancy. Meropenem and imipenem can be used as the main antibiotic alternatives. Other effective drugs include cefoxitin, piperacillin and cefoperazone. In clinic, the appropriate antibiotics should be selected according to the characteristics of medication for pregnancy.

Key words: pregnancy, acute appendicitis, pathogenic bacteria