论文：肠道菌群失调症Ⅱ和Ⅲ度原因菌分布及药敏试验分析,论文

【摘要】目的了解住院病人Ⅱ和Ⅲ度菌群失调的原因菌分布及其耐药特征,为临床治疗Ⅱ和Ⅲ度菌群失调及由原因菌引起的内源性感染提供抗生素选药依据。方法将新鲜粪便标本用涂片+革兰染色镜检作微生态学检查,挑选Ⅱ和Ⅲ度菌群失调的大便标本进行培养鉴定和药敏试验分析,将结果用湖南天地人细菌分析鉴定系统做原因菌分布和耐药性统计分析。结果引起Ⅱ和Ⅲ度菌群失调原因菌按比例大小依次为肠球菌31.9%，酵母样真菌27.24%，变形菌属16.34%，铜绿假单胞菌6.23%，柠檬酸杆菌属5.84%，克雷伯菌5.45%，产毒素A的难辨梭菌5.06%，金黄色葡萄球菌属1.94%，其中酵母样真菌对两性霉素B和制霉菌素无耐药性,铜绿假单胞菌、变形菌属和克雷伯菌属对美罗培南和亚胺培南无耐药性,80%的金黄色葡萄球菌为耐甲氧西林金黄色葡萄球菌（MRSA）,且对米诺环素、呋喃妥因、夫西地酸、万古霉素、替考拉宁和喹奴普汀-达福普汀无耐药性。结论治疗Ⅱ和Ⅲ度菌群失调的方案必须结合原因菌和内源性感染菌药敏试验,选用有针对性的抗生素才能有效的去除病源因子。

【关键词】菌群失调;细菌;真菌;耐药率;微生态学检查

【Abstract】ObjectiveTounderstandthedistributiveofcausativebacteriaandtheirchracteristicsofdrugresistance,andtoprovidebasisforchoosethemedicineonantibioticsfortheclinicaltreatmentofⅡandⅢdegreeintestinaltractdysbacteriosisandinternalinfectioncausedbydifferentcausativebacteriainin-patients.MethodsMicroecologicalexaminationoffreshstoolsamplesweredonebymakingsmearandGramstainthenobservedwithmicroscopeforpickingoutthestoolsamplesofⅡandⅢdegreeinestinaltractdysbacteriosistocultureandidentifybacteriathenanalyzedtheirdrugresistancebydoingdrugsensiviticalexperiment,thestatisticsanalysisoncalculatingcausativebacteriaandtheirdrugresistanceweredonebyHUNAN-SKY-FIELD-PERSONsystem.ResultsCausativebacteriaforⅡandⅢinestinaltractdysbacteriosisinordewereEnterococci（31.9%）,yeast-likefungi（27.24%）,Proteus（16.34%）,Pseudomonasaeruginosa（6.23%）,Citrobacter（5.84%）,Klebsiella（5.45%）,toxinAproductingClostridiumdifficile（5.06%）,andStaphylococcusaureus（1.94%）.Theyeast-likefungihadnodrugresistancetoamphotericinBandnystain,theP.aeruginosa,ProteusandKlebsiellahadnodrugresistancetoimipenemandmeropenem,80%S.aereuswereMRSA,andhadnodrugresistancetominoycline,nitrofurantoin,fusidicacid,vancomycin,teicoplaninandquinupristin-dalfopristin.ConclusionTakentreatmentprojectforⅡandⅢintestinaltractdysbacteriosismustcombindthedrugsensitivityexperimentfortheircausativebacteriaandinternalinfectionfungiandunderstandtheirdrugresistancemechanisminordertochoosepertinencydrugforremo