【摘要】 目的探讨肝移植术后感染病原菌分布及耐药性,为防治术后感染提供依据。方法分析我院2004年12月～2005年12月肝移植病区各类标本分离的236株病原菌的分布及耐药性,并进行ESBLS、AmpC、MRSA、MRCNS、VRE的检测。结果病原菌分离部位以痰液、胆汁、血液为主,占75.8%。共分离菌株236株,以大肠埃希菌、溶血葡萄球菌、肺炎克雷伯菌、屎肠球菌、铜绿假单胞菌、阴沟肠杆菌、白假丝酵母菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌、表皮葡萄球菌多见,占95.8%。大肠埃希菌和肺炎克雷伯菌的ESBLS分别为59.4%和62.1%,AmpC为31.3%和34.5%,MRCNS为82.9%,VRE为14.3%。分离细菌的耐药现象严重。结论肝移植术后易并发生感染,并以多重耐药菌多见,应加强耐药监测,经验用药可选择碳青霉烯类、含β-内酰胺酶抑制剂类复合药及糖肽类抗菌药。更多还原

【Abstract】 Objective to study the distribution and drug resistance of infective pathogens in the Patients after Liver Transplantation, to provide evidence for prevention against and treatment of infection after Liver Transplantation. Methods The distribution and drug resistance of bacterial infections in the patients after liver transplantation were carried out in 236 strains from various specimens,2004.12-2005.12. The ESBLS、AmpC、MRCNS、VRE were tested at the same time. Results The main sites for pathogens were sputum, bile and blood (75.8%).Totally 236 strains were separated, The most common strains were Escherichia coli, Staphylococcus haemolysis, klebsiella pneumoniae, Enterococus faecium, Pseudomonas aeruginosa, Enterobacter cloacae, Candida albicans, Acinetobacter baumannii, Stenotrophomonas maltophilia, for Escherichia coli and klebsiella pneumoniae, the percent- age of strains producing ESBLS were 59.4% and 62.1%. And the percentage of AmpC were 31.3% and 34. 5%,MRCNS was 82.9%,VRE was 14.3% respectively. The status of bacterium drug resistance was very severe.Conclusions The infection incidence of bacterial and fungal infections after liver transplantation. was very high, and most strains manifested multi-drug resistance, it is very important to strengthen drug resistance inspection, carbopenems, β-lactamases inhibitor were better antibiotics for treatment of the infection.更多还原