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目的:研究肝硬化并自发性腹膜炎腹水细菌谱并对肝硬化并自发性腹膜炎腹水抗菌药进行耐药性分析。方法:抽取平舆县中心医院2016年1月至2016年6月收诊的146例腹水培养细菌呈现阳性的肝硬化并发自发性腹膜炎腹水感染患者,对对应的培养的细菌进行细菌谱和耐药性分析,与此同时,做好记录和统计分析。结果:腹水感染细菌大肠埃希菌76例,占52.05%;肺炎克雷伯菌16例,占10.96%;表皮葡萄球菌14例,占9.59%;粪球菌14例,占9.59%;铜绿假单胞菌10例,占6.85%;结核杆菌10例,占6.85%;其他细菌6例,占4.11%。通过抗药性研究可以发现,大肠埃希菌对氨苄西林、头孢噻吩、环丙沙星的耐药率高;对头孢吡肟、头孢哌酮、阿米卡星耐药率则相对较低。结论:肝硬化并发自发性腹膜炎腹水感染细菌主要以大肠埃希菌为主,肺炎克雷伯菌、表皮葡萄球菌、粪球菌、铜绿假单胞菌、结核杆菌及其他细菌相对较少。就药物抗性而言,几种常用抗菌药耐药性较高,在肝硬化并自发性腹膜炎腹水感染的治疗过程中应当合理地使用抗菌药。
Objective: To study the bacterial spectrum of ascites in patients with cirrhosis and spontaneous peritonitis and analyze the drug resistance of cirrhotic patients with spontaneous peritonitis and ascites. Methods: 146 cases of ascites cultured in Pingyu County Central Hospital from January 2016 to June 2016 were enrolled in this study. The patients with spontaneous peritonitis and ascites were positive for bacterial culture and drug resistance Sex analysis, at the same time, do a good job of recording and statistical analysis. Results: Ascites was infected with Escherichia coli in 76 cases (52.05%), Klebsiella pneumoniae in 16 cases (10.96%), Staphylococcus epidermidis in 14 cases (9.59%) and Bacillus faecalis (9.59%). Mycobacterium in 10 cases, accounting for 6.85%; Mycobacterium tuberculosis in 10 cases, accounting for 6.85%; other bacteria in 6 cases, accounting for 4.11%. Through drug resistance study, we can find that Escherichia coli has high drug resistance rate to ampicillin, cefalotin and ciprofloxacin, while the rate of resistance to cefepime, cefoperazone and amikacin is relatively low. CONCLUSION: Escherichia coli is the main bacterial source of bacterial infection in patients with cirrhosis and spontaneous peritonitis. Klebsiella pneumoniae, Staphylococcus epidermidis, Staphylococcus epidermidis, Pseudomonas aeruginosa, Mycobacterium tuberculosis and other bacteria are relatively rare. In terms of drug resistance, several commonly used antibacterials are more resistant and antibacterials should be used reasonably in the treatment of cirrhosis and spontaneous peritonitis with ascites infection.