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一家三级护理医院腹腔内感染的细菌学概况

Bacteriological profile of intra-abdominal infections in a tertiary care hospital.

作者信息

Sudhaharan Sukanya, Kanne Padmaja, Vemu Lakshmi, Chavali Padmasri, Desmukha Shanker Rao, Nagari Bheerappa

机构信息

Nizam's Institute of Medical Sciences Panjagutta, Hyderabad, Telangana, India.

出版信息

Iran J Microbiol. 2018 Aug;10(4):208-214.

Abstract

BACKGROUND AND OBJECTIVES

Intra-abdominal infections (IAIs) include a wide spectrum of pathological conditions, ranging from uncomplicated appendicitis to fecal peritonitis .The resulting infections should be diagnosed early and treated based on the organism isolated and its susceptibility. In this study the bacteriological profile and antimicrobial resistance pattern of intra-abdominal infections was analyzed.

MATERIALS AND METHODS

A retrospective analysis of samples received from 119 cases of intra-abdominal infections in our Institute from January 2015 to December 2017 was analyzed. Patients with primary peritonitis from cirrhosis or ascites were not included in the study. The specimens were primarily processed, as per standard methods. Identification and antimicrobial susceptibility testing was done by the Vitek-2 system. Anaerobic culture was performed on 5% sheep blood agar plates and incubated in GEN bag anaerobic pouches.

RESULTS

In our study perforative peritonitis 43/119 (36.1%) was predominant IAI followed by acute pancreatitis 14/119 (11.7%) and pancreatic necrosis 12/119 (10%). Microbial growth was observed in 66.3% (79/119) of the cases and combined infections were observed in14/119 (11.7%) of the cases. was the predominant organism isolated in 58/119 (40.8%), out of which 41/58 (70.6%) were ESBL producers and 16/58 (27.5%) were multi drug resistant isolates. was isolated from 11/119 (9.2%) cases out of which 8/11 (72.7%) were ESBL and 3/11 (27.2%) were multidrug resistant isolates. Post-operative complications was observed in 12/119 (10%) patients with mortality in 15/119 (12.6%) patients.

CONCLUSION

Early diagnosis and appropriate management of the infections will help to prevent the morbidity and mortality associated with these infections.

摘要

背景与目的

腹腔内感染(IAIs)包括从单纯性阑尾炎到粪性腹膜炎等广泛的病理状况。由此引发的感染应尽早诊断,并根据分离出的病原体及其药敏情况进行治疗。本研究分析了腹腔内感染的细菌学特征及抗菌药物耐药模式。

材料与方法

对2015年1月至2017年12月我院收治的119例腹腔内感染患者的样本进行回顾性分析。肝硬化或腹水所致原发性腹膜炎患者未纳入本研究。标本按照标准方法进行初步处理。采用Vitek-2系统进行鉴定和抗菌药物敏感性试验。在5%羊血琼脂平板上进行厌氧培养,并置于GEN袋厌氧培养盒中孵育。

结果

在我们的研究中,穿孔性腹膜炎43/119(36.1%)是主要的腹腔内感染类型,其次是急性胰腺炎14/119(11.7%)和胰腺坏死12/119(10%)。66.3%(79/119)的病例观察到微生物生长,14/119(11.7%)的病例观察到混合感染。大肠埃希菌是58/119(40.8%)中分离出的主要病原体,其中41/58(70.6%)产超广谱β-内酰胺酶(ESBL),16/58(27.5%)是多重耐药菌株。肺炎克雷伯菌从11/119(9.2%)的病例中分离出,其中8/11(72.7%)产ESBL,3/11(27.2%)是多重耐药菌株。12/119(10%)的患者出现术后并发症,15/119(12.6%)的患者死亡。

结论

对感染进行早期诊断和适当处理有助于预防与这些感染相关的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2e9/6243144/8377ef63f260/IJM-10-208-g001.jpg

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