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目的分析因重症急性胰腺炎行引流手术且术后合并胰腺感染患者的细菌学及药敏报告,为重症急性胰腺炎术后感染的抗生素应用提供临床参考。方法收集2003年1月—2006年4月间86例重症急性胰腺炎术后患者腹腔引流物标本,对标本进行细菌培养,检测菌株对抗生素的耐药情况。结果 86例患者中共分离出276株细菌,检出率分别为阴沟肠杆菌(12.3%)、铜绿假单胞菌(10.9%)、金黄色葡萄球菌(9.4%)、其他葡萄球菌(9.4%)、D 群链球菌(9.4%)、粪肠球菌(8.7%)、大肠埃希菌(8.7%)、表皮葡萄球菌(6.5%)、肺炎克雷伯菌(4.3%)、屎肠球菌(4.3%)。药敏分析及耐药试验表明重症急性胰腺炎术后胰腺感染耐药严重,对于革兰阳性球菌,万古霉素和替考拉宁尚保持了较好的抗菌活性,对于革兰阴性杆菌仅碳青酶烯类抗生素对其存在较好的抗菌活性。结论对重症急性胰腺炎术后胰腺感染患者,大部分菌株广泛耐药,临床上应依据细菌药物敏感性结果,不断调整抗生素。
Objective To analyze the bacteriological and drug susceptibility reports of patients with severe acute pancreatitis who underwent drainage and postoperative pancreatic infection and provide a clinical reference for the application of antibiotics in postoperative infection of severe acute pancreatitis. Methods Totally 86 patients with severe acute pancreatitis underwent peritoneal drainage from January 2003 to April 2006 were collected for bacterial culture to detect the antibiotic resistance of the strains. Results A total of 276 strains of bacteria were isolated from 86 patients. The detection rates were Enterobacter cloacae (12.3%), Pseudomonas aeruginosa (10.9%), Staphylococcus aureus (9.4%), Staphylococcus aureus , Streptococcus group D (9.4%), Enterococcus faecalis (8.7%), Escherichia coli (8.7%), Staphylococcus epidermidis (6.5%), Klebsiella pneumoniae (4.3%), Enterococcus faecium %). Drug susceptibility analysis and drug resistance tests showed that pancreas infection in severe acute pancreatitis was severely drug-resistant and maintained good antibacterial activity against gram-positive cocci, vancomycin and teicoplanin. For gram-negative bacilli, only carbon Chlase antibiotics have good antibacterial activity. Conclusion Most patients with pancreas infection in pancreas after severe acute pancreatitis are widely resistant to antibiotics, and antibiotics should be adjusted according to the results of bacterial drug sensitivity.