剖宫产术后脓毒症病原菌分布与耐药性分析
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摘要
目的分析剖宫后术后脓毒症的病原菌分布及耐药状况。方法回顾性分析2012年1月至2017年12月我院产科住院患者剖宫产术后败血症患者血标本,常规进行细菌培养和鉴定,根据美国实验室标准化研究所(CLSI)标准按纸片法、微量稀释法或E-test法测定细菌药物敏感性。结果共分离74株致病菌,革兰氏阳性球菌占71. 6%,革兰氏阴性杆菌占28. 4%。排在前6位的依次是大肠埃希菌、粪肠球菌、咽颊炎链球菌、无乳链球菌、草绿色链球菌、金黄色葡萄球菌,分别占24. 3%,16. 2%,13. 5%,9. 5%,8. 1%和5. 4%。葡萄球菌中未检出对利奈唑胺、万古霉素耐药菌株。产超广谱β内酰胺酶(ESBLs)阳性大肠埃希菌检出率61. 1%。结论剖宫产术后脓毒症以大肠埃希菌、粪肠球菌和链球菌为主。
To investigate the distribution of pathogens and antibiotic resistance of post-cesarean sepsis. Methods The blood samples were performed in post-cesarean sepsis from January 2012 to December 2017 in our hospital. The samples were cultured and identified by conventional method,and their susceptibility were tested by disk diffusion,microbroth dilution or E-test according to Clinical and Laboratory Standard Institute( CLSI 2015) manual. Results Of the 74 clinical isolates,gram-positive bacteria and gram-negative bacteria accounted for 71. 6% and28. 4%, respectively. The six main bacterias were Eshceichia coli( 24. 3%),Enterococcus faecalis( 16. 2%),Streptococcus pharyngitis( 13. 5%), Streptococcus agalactiae( 9. 5%),streptococcus viridans( 8. 1%),Staphylococcus aureus( 5. 4%). No strains resistant to vancomycin and linezolid were detected in staphylococci. Extended-spectrumβ-lactamase( ESBL)-producing strains accounted for 61. 1% in Eshceichia coli. Conclusion Eshceichia coli,Enterococcus faecalis and Streptococcus are the main pathogens in patients with post-cesarean sepsis.
To investigate the distribution of pathogens and antibiotic resistance of post-cesarean sepsis. Methods The blood samples were performed in post-cesarean sepsis from January 2012 to December 2017 in our hospital. The samples were cultured and identified by conventional method,and their susceptibility were tested by disk diffusion,microbroth dilution or E-test according to Clinical and Laboratory Standard Institute( CLSI 2015) manual. Results Of the 74 clinical isolates,gram-positive bacteria and gram-negative bacteria accounted for 71. 6% and28. 4%, respectively. The six main bacterias were Eshceichia coli( 24. 3%),Enterococcus faecalis( 16. 2%),Streptococcus pharyngitis( 13. 5%), Streptococcus agalactiae( 9. 5%),streptococcus viridans( 8. 1%),Staphylococcus aureus( 5. 4%). No strains resistant to vancomycin and linezolid were detected in staphylococci. Extended-spectrumβ-lactamase( ESBL)-producing strains accounted for 61. 1% in Eshceichia coli. Conclusion Eshceichia coli,Enterococcus faecalis and Streptococcus are the main pathogens in patients with post-cesarean sepsis.
引文
[1]郑新,刘伟武,刘丽梅等.剖宫产术后败血症危险因素分析[J].中国感染控制杂志,2018,17(2):136-140.
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[4] TEO K P,JACOB S C,LIM S H,et al. Post-caesarean septicaemia in Kandang Kerbau Hospital,Singapore,1993-1995[J]. Med J Malaysia,1997,52(4):325-330.
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[6]余海燕,周容,刘兴会,等.妊娠合并败血症19例[J].中国妇幼保健,2008,23(2):763-766.
[2] CLSI. Clincal and laboratory Standards Institute(CLSI)2015[EB/OL]. Wayne:CLSI,2015-01-31[2016-01-04].http://us. findeen. com/clsi_m100_s25. html.
[3] BUSTREO F,SAY L,KOBLINSKY M,et al. Ending preventable maternal deaths:the time is now[J]. Lancet Gold Health,2013,1(4):176-177.
[4] TEO K P,JACOB S C,LIM S H,et al. Post-caesarean septicaemia in Kandang Kerbau Hospital,Singapore,1993-1995[J]. Med J Malaysia,1997,52(4):325-330.
[5]宁细容,王秀红.克雷伯杆菌致产后败血症1例[J].中国社区医师,2010,15(12):172.
[6]余海燕,周容,刘兴会,等.妊娠合并败血症19例[J].中国妇幼保健,2008,23(2):763-766.