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目的探讨肝硬化失代偿期患者感染病原菌分布与耐药情况。方法回顾性分析300例肝硬化失代偿期患者的临床资料,分析其感染病原菌分布及耐药情况。结果 300例肝硬化失代偿期患者中共有26例患者发生感染,感染率为8.7%,从患者检查标本中共分离出病原菌60株,包括革兰阳性菌(22株)、革兰阴性菌(34株)以及真菌(4株)。革兰阴性菌对哌拉西林、美罗培南和亚胺培南的耐药率均为0,而对头孢他啶药物的耐药率为29.0%,对阿莫西林、头孢吡肟、氨曲南及庆大霉素耐药率为60.0%~80.0%;革兰阳性杆菌对万古霉素的耐药率为0,对哌拉西林、美罗培南和亚胺培南耐药率为50.0%~60.0%,对头孢唑啉、阿奇霉素的耐药率为10.0%。结论肝硬化失代偿期患者发生感染时其病原菌具有交叉耐药和多重耐药的特点,因此医院需加强监控,临床医生则应根据其药敏试验结果合理选取抗菌药物,进而提高患者临床治疗效果,改善患者预后生活质量。
Objective To investigate the distribution and drug resistance of pathogens in patients with decompensated cirrhosis. Methods The clinical data of 300 patients with decompensated liver cirrhosis were retrospectively analyzed. The distribution and drug resistance of the pathogens were analyzed. Results A total of 26 out of 300 patients with decompensated liver cirrhosis were infected with the infection rate of 8.7%. Sixty pathogens were isolated from the patients, including Gram-positive bacteria (22 strains), Gram-negative bacteria 34 strains) and fungi (4 strains). The resistance rate of Gram-negative bacteria to piperacillin, meropenem and imipenem was 0, while the resistance rate to ceftazidime was 29.0%. The resistance rates to amoxicillin, cefepime, aztreonam and azithromycin The rates of resistance to gentamicin were 60.0% -80.0%. The rates of resistance to vancomycin in Gram-positive bacilli were 0, and the rates of resistance to piperacillin, meropenem and imipenem were 50.0% -60.0% Resistance to cefazolin and azithromycin was 10.0%. Conclusion In patients with decompensated liver cirrhosis, the pathogenic bacteria have the characteristics of cross-resistance and multi-drug resistance. Therefore, the hospital should strengthen the monitoring, and clinicians should select antibiotics reasonably according to the results of drug susceptibility test to improve the clinical treatment of patients Effect, improve the prognosis of patients with quality of life.