青年与老年男性肛周脓肿病原菌分布及药敏差异分析OA

Objective To investigate the distribution characteristics of pathogenic bacteria in the purulent fluid of young male patients with perianal abscess and their antibiotic sensitivities,thereby guiding the rational use of antimicrobial agents in clinical practice.Methods Pus specimens from 189 hospitalized patients with primary suppurative perianal abscess who underwent surgical treatment in the Department of Proctology at 908th Hospital of the Joint Logistics Support Force from February 2023 to February 2025 were collected for culture and antibiotic susceptibility testing.These samples underwent culture and antimicrobial susceptibility analysis.Patients were divided into a young male group(n=128)and an elderly male group(n=61)based on age.Bacterial culture and susceptibility test results were compared between the two groups.Results In the young male group,among the pus specimens of perianal abscess,84 cases(65.63%)were detected with a single facultative anaerobe,6 cases(4.69%)with a single obligate anaerobe,11 cases(8.59%)with mixed infection,and 27 cases(21.09%)with no bacteria cultured.In the elderly male group,among the perianal pus specimens,51 cases(83.60%)were detected with a single facultative anaerobe,3 cases(4.92%)with a single obligate anaerobe,4 cases(6.56%)with mixed infection,and 3 cases(4.92%)with no bacteria cultured.The comparison of bacterial detection rates between the two groups showed a statistically significant difference(P<0.05).The detection rates of Escherichia coli in the two groups were 35.94%(46/128)and 52.46%(32/61)respectively;the rates of Klebsiella pneumoniae were 14.84%(19/128 cases)and 14.75%(9/61)respectively;the rates of Staphylococcus aureus were 7.81%(10/128)and 4.92%(3/61)respectively.All the detected single obligate anaerobes were Bacteroides fragilis.The detection rates of extended-spectrum β-lactamase-producing Escherichia coli(ESBL-producing E.coli)in the two groups were 26.09%(12/46)and 53.13%(17/32)respectively,with a statistically significant difference(P<0.05).Antimicrobial susceptibility test results showed that in the young male group,the Gram-negative bacilli had a relatively high susceptibility rate of 98.51%(66/67)to cefoxitin,the susceptibility rates to ertapenem and imipenem were 98.57%(69/70)and 94.29%(66/70)respectively,and the susceptibility rates to cephalosporins including cefuroxime,ceftazidime and cefepime were 67.65%(46/68),77.14%(54/70)and 80.00%(56/70)respectively.The Staphylococcus aureus strains in both groups showed a 100.00%susceptibility rate to daptomycin,vancomycin,linezolid and moxifloxacin.In the young male group,the Gram-positive cocci had a susceptibility rate of 64.29%(9/14)to erythromycin.Conclusions For perianal abscess in young males,antimicrobial therapy may prioritize cephamycins such as cefoxitin,which covers both obligate and facultative anaerobes.A significant difference exists in the detection rate of ESBL-producing E.coli between young and elderly males,with a higher rate observed in the elderly group.Based on the characteristics and susceptibility profiles of the pathogens,timely adjustment to effective antimicrobial agents is recommended.