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腹部创伤所致严重腹腔内感染患者脓液的细菌学及药敏分析

Bacteriology and drug susceptibility analysis of pus from patients with severe intra-abdominal infection induced by abdominal trauma.

作者信息

Zhang Shaoyi, Ren Lele, Li Yousheng, Wang Jian, Yu Wenkui, Li Ning, Li Jieshou

机构信息

Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, P.R. China.

出版信息

Exp Ther Med. 2014 May;7(5):1427-1431. doi: 10.3892/etm.2014.1609. Epub 2014 Mar 6.

Abstract

The aim of the present study was to retrospectively analyze the bacteriology and drug susceptibility of pus flora from abdominal trauma patients with severe intra-abdominal infection (SIAI). A total of 41 patients with SIAI induced by abdominal trauma were enrolled in the study, from which 123 abdominal pus samples were obtained. The results from laboratory microbiology and drug sensitivity were subjected to susceptibility analysis using WHONET software. A total of 297 strains were isolated in which Gram-negative bacteria, Gram-positive bacteria and fungi accounted for 53.5 (159/297), 44.1 (131/297) and 0.7% (2/297), respectively. Anaerobic bacteria accounted for 1.7%. The five predominant bacteria were (), (), (), and (). was highly susceptible to cefoperazone (91%) and imipenem (98%), while Gram-positive cocci were highly susceptible to teicoplanin (100%) and linezolid (100%). was 100% susceptible to vancomycin and was highly susceptible to imipenem (100%) and amikacin (79%). was the most susceptible to ciprofloxacin (90%). Gram-negative bacterial infection was present in the majority of cases of SIAI. However, a large number of patients were infected by Gram-positive bacteria, particularly that exhibited significant resistance to penicillin (100%), oxacillin (100%) and a third-generation cephalosporin antibiotic cefotaxime (95%). Amongst the pathogenic bacteria that cause SIAI, both Gram-negative and Gram-positive bacteria account for a high proportion, so high-level and broad-spectrum antibiotics should be initially used.

摘要

本研究旨在回顾性分析腹部创伤致严重腹腔感染(SIAI)患者腹腔脓液菌群的细菌学及药敏情况。本研究共纳入41例因腹部创伤导致SIAI的患者,从中获取了123份腹腔脓液样本。实验室微生物学及药敏结果采用WHONET软件进行药敏分析。共分离出297株菌株,其中革兰阴性菌、革兰阳性菌和真菌分别占53.5%(159/297)、44.1%(131/297)和0.7%(2/297)。厌氧菌占1.7%。五种主要细菌为(此处原文缺失具体细菌名称)。(此处原文缺失具体细菌名称)对头孢哌酮(91%)和亚胺培南(98%)高度敏感,而革兰阳性球菌对替考拉宁(100%)和利奈唑胺(100%)高度敏感。(此处原文缺失具体细菌名称)对万古霉素100%敏感,(此处原文缺失具体细菌名称)对亚胺培南(100%)和阿米卡星(79%)高度敏感。(此处原文缺失具体细菌名称)对环丙沙星最敏感(90%)。大多数SIAI病例存在革兰阴性菌感染。然而,大量患者感染革兰阳性菌,尤其是(此处原文缺失具体细菌名称)对青霉素(100%)、苯唑西林(100%)和第三代头孢菌素抗生素头孢噻肟(95%)表现出显著耐药性。在导致SIAI的病原菌中,革兰阴性菌和革兰阳性菌所占比例均较高,因此初始应使用高级别、广谱抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b95/3991502/83c7492ed3bd/ETM-07-05-1427-g00.jpg

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