目的 分析厌氧菌标本来源、科室、年龄分布特征及药敏试验结果,为临床经验性治疗和合理使用抗菌药物提供依据.方法 收集2015年1月—2017年11月承德医学院附属医院住院患者所有合格标本中的厌氧菌,经VITEK2 compact ANC进行菌株鉴定,所有菌株使用头孢硝噻吩法检测β-内酰胺酶,使用浓度梯度药敏实验方法检测菌株对13种抗菌药物的敏感性.结果 分离出厌氧菌260株,其中,厌氧消化链球菌94株(36.15％)、脆弱拟杆菌81株(31.15％)、艰难梭菌42株(16.15％)、普雷沃菌属16株(6.15％)、产气荚膜梭菌11株(4.23％);除艰难梭菌标本来源为粪便外,其他厌氧菌主要分离自脓液;分离厌氧菌最多的科室为产科、老年病科及血液科.药敏结果显示,79株厌氧菌的β-内酰胺酶试验阳性,阳性率为30.4％;脆弱拟杆菌β-内酰胺酶87.6％为阳性,产酶率最高.厌氧消化链球菌对阿莫西林/克拉维酸、替卡西林/克拉维酸、哌拉西林/三唑巴坦100％敏感;脆弱拟杆菌对阿莫西林/克拉维酸、哌拉西林/三唑巴坦敏感率100％;艰难梭菌对氨苄西林/舒巴坦、哌拉西林/三唑巴坦敏感率100％;普雷沃菌属对阿莫西林/克拉维酸、氨苄西林/舒巴坦、替卡西林/克拉维酸敏感率100％;产气荚膜梭菌对青霉素、氨苄西林敏感率100％.甲硝唑对所有菌株均保持很高的敏感性.结论 厌氧菌引起的临床感染常见,不同厌氧菌的分布及药敏结果不尽相同,临床医生可根据菌株的分布特征及药敏结果对厌氧菌感染进行更有效的治疗.%Objective Analyzing specimen sources,distribution characteristics and drug sensitivity test results of anaerobe in clinical infections to provide the basis for clinical empiric treatment and using of antibacterial agents reasonably.Methods We collected qualified strains from January 2015 to November 2017 in inpatient of the Affiliated Hospital of Chengde Medical College.The strains were identified by the VITEK2 compact ANC.The sensitivity of the strains to antimicrobial agents were detected by the concentration gradient antimicrobial test.The secreted ⊥β-lactamase were detected using cephalothiophene disks.Results 260 strains of anaerobe were isolated and identified in our hospital.There were 94 strains ofPeptostreptococcus anaerobia (36.15％),81 strains of bacteroides fragilis (31.15％),42 strains of Clostridium difficile (16.15％),16 strains of Prevotella (6.15％) and 11 strains of Clostridium perfringens (4.23％).Anaerobic bacteria were mainly isolated from abscess except Clostridium difficile which came from faeces.The departments which isolated the most of anaerobic bacteria were obstetric,geriatrics and department of Hematology.The drug sensitivity tests showed that 79 strains of anaerobic bacteria were positive for beta-lactamase,of which the positive rate was 30.4％.The enzyme production of beta-lactamase was the highest in B.fragilis,and the positive rate was 87.2％.Peptostreptococcus anaerobius were fully sensitive to amoxicillin/ clavulanic acid,ticarcillin/clavulanic acid,and Piperacillin/tazobactam.B.fragilis were fully sensitive to amoxicillin/ clavulanic acid,piperacillin/tazobactam.Clostridium difficile were fully sensitive to ampicillin/sulbactam and piperacillin/tazobactam.Prevotella were fully sensitive to amoxicillin/clavulanic acid,ampicillin/sulbactam,and ticarcillin/clavulanic acid.Clostridium perfringens were fully sensitive to penicillin and ampicillin.All strains were highly sensitive to metronidazole.Conclusions The clinical infections caused by anaerobic bacteria were common.The distribution and drug sensitivity of different anaerobic bacteria were different.Clinicians should be more effective in the treatment of anaerobic infections according to their distribution characteristics and drug sensitivity.
展开▼
