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目的了解肝硬化合并自发性细菌性腹膜炎(SBP)患者的病原菌及其耐药情况。方法对56例肝硬化合并自发性细菌性腹膜炎细菌培养阳性者进行分析。结果肝硬化患者合并SBP的病原菌为革兰阴性菌,占64.28%,其中大肠埃希菌占35.71%,其次为肺炎克雷伯菌占16.07%;革兰阳性菌占32.15%,主要是金黄色葡萄球菌(12.50%)、表皮葡萄球菌(8.93%)和粪肠球菌(5.36%);白色假丝酵母菌2株(3.57%);三代头孢菌素与三代喹诺酮类药物的耐药率明显增加,而临床上使用较少的氨基糖苷类抗菌药物对大肠埃希菌的耐药率较低;美罗培南、亚胺培南、替考拉宁和万古霉素的耐药率低。结论尽可能对肝硬化患者合并腹水患者进行腹腔穿刺检查,根据药敏试验结果合理选择抗菌药物。
Objective To understand the pathogen and drug resistance of patients with cirrhosis and spontaneous bacterial peritonitis (SBP). Methods Fifty-six patients with cirrhosis and spontaneous bacterial peritonitis were tested for bacterial culture. Results The pathogens of patients with cirrhosis complicated with SBP were gram-negative bacteria accounting for 64.28%, of which Escherichia coli accounted for 35.71%, Klebsiella pneumoniae 16.07%, Gram-positive bacteria 32.15%, mainly golden yellow Staphylococcus aureus (12.5%), Staphylococcus epidermidis (8.93%) and Enterococcus faecalis (5.36%); Candida albicans 2 strains (3.57%); Third-generation cephalosporins and three generations of quinolones were significantly increased , While the aminoglycoside antibiotics used less clinically had a lower resistance rate to Escherichia coli. The rates of resistance of meropenem, imipenem, teicoplanin and vancomycin were low. Conclusion As far as possible in patients with cirrhosis and ascites in patients with abdominal paracentesis, according to drug susceptibility test results reasonable choice of antimicrobial agents.