目的 了解江蘇省人民醫(yī)院肝移植術(shù)后感染病原菌的分布及耐藥性,為臨床合理用藥提供參考。方法 對2012年1月—2015年1月江蘇省人民醫(yī)院肝移植術(shù)后感染病原菌的分布及耐藥性進行統(tǒng)計分析。結(jié)果 共分離出病原菌1 380株,主要來源于痰液標本。病原菌分布以革蘭陰性菌為主,占69.57%,革蘭陽性菌和真菌分別占20.07%、10.36%;其中革蘭陰性菌以鮑曼不動桿菌、肺炎克雷伯菌為主,革蘭陽性菌以溶血葡萄球菌為主;革蘭陰性菌對美羅培南、阿米卡星、亞胺培南較為敏感,耐藥率均低于30%,對頭孢曲松、氨曲南等的耐藥率均較高;革蘭陽性菌對萬古霉素、利奈唑胺、替考拉寧較為敏感,耐藥率均低于20%,對氨芐西林、諾氟沙星等耐藥率均較高。結(jié)論 肝移植術(shù)后感染病原菌的構(gòu)成主要是鮑曼不動桿菌、肺炎克雷伯菌和溶血葡萄球菌,臨床選擇抗菌藥物時建議選用病原菌表現(xiàn)較低耐藥性的美羅培南、阿米卡星、萬古霉素、利奈唑胺等藥物。

Objective To investigate the distribution and drug resistance of pathogenic bacteria infected after liver transplantation in Jiangsu Province Hospital, and to provide reference for clinical reasonable use of antibiotics. Methods The distribution and drug resistance of pathogenic bacteria infected after liver transplantation in Jiangsu Province Hospital from January 2012 to January 2015 were statistically analyzed. Results Totally 1 380 strains of pathogens were isolated, and the pathogenic bacteria was isolated mainly from sputum samples. Gram-negative bacteria were the main pathogenic bacteria and accounted for 69.57%. Gram-positive bacteria and fungus accounted for 20.07% and 10.36%, respectively. Gram-negative bacteria mainly consisted of Acinetobacter bauamnnii and Klebsiella pneumoniae. Gram-positive bacteria mainly consisted of Staphylococcus haemolyticus. Main Gram-negative bacteria were sensitive to meropenem, amikacin, and imipenem, and the drug resistance rate was lower than 30%. And they were highly resistant to ceftriaxone and aztreonam. Main Gram-positive bacteria were sensitive to vancomycin, linezolid, and teicoplanin and the drug resistance rate was lower than 20%. And they were highly resistant to ampicillin and norfloxacin. Conclusion The main pathogens infected after liver transplantation are A. baumannii, K. pneumoniae, and S. aureus, and it is suggested to choose antimicrobial drugs with lower resistance, such as meropenem, amikacin, vancomycin, and linezolid.

江蘇省六大人才高峰基金項目(NO2014-WSW-005)