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目的探讨肝病并发自发性细菌性腹膜炎(SBP)患者腹水中大肠埃希菌的耐药情况,为临床合理应用抗菌药物提供依据。方法对2011年10月-2014年10月,济南市传染病医院收治的肝病并发SBP患者腹水标本中大肠埃希菌的药敏试验结果及超广谱β-内酰胺酶(ESBLs)检测结果进行回顾性分析。结果患者腹水中分离的105株大肠埃希菌对16种临床常用抗菌药物产生了不同程度的耐药。产ESBLs菌株的检出率为41%,耐药率均高于非产ESBLs菌株,其中对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦及头孢吡肟的耐药率<40%,对亚胺培南/西司他丁的耐药率为5%,对美罗培南与比阿培南未产生耐药。结论山东济南地区肝病并发SBP患者抗感染治疗的经验性用药可选择哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢吡肟,严重感染者可首选碳青霉烯类抗菌药物。
Objective To investigate the drug resistance of Escherichia coli in ascitic fluid in patients with liver disease complicated with spontaneous bacterial peritonitis (SBP), and to provide a basis for clinical rational use of antibacterial drugs. Methods From October 2011 to October 2014, the results of susceptibility testing of Escherichia coli and the detection of extended-spectrum β-lactamases (ESBLs) in ascites from patients with liver disease complicated by SBP in Jinan Infectious Disease Hospital Retrospective analysis. Results 105 strains of Escherichia coli isolated from ascites in patients had different degrees of resistance to 16 commonly used antibiotics. The detection rate of ESBLs-producing strains was 41%, and the drug resistance rate was higher than that of non-ESBLs-producing strains. The resistance rate to piperacillin / tazobactam, cefoperazone / sulbactam and cefepime was <40 %, Resistant to imipenem / cilastatin 5%, no resistance to meropenem and biapenem. Conclusions Piperacillin / tazobactam, cefoperazone / sulbactam, and cefepime may be the empirical choice for anti-infective therapy in patients with liver disease and SBP in Jinan, Shandong Province. The carbapenem antibiotics .