肛周脓肿热毒炽盛证患者大肠埃希菌耐药特征及耐药基因检测分析OA
Analysis of Drug Resistance Characteristics and Drug Resistance Gene Detection of Escherichia coli in Patients with Perianal Abscess of Heat-Toxin Exuberance Syndrome
目的:分析肛周脓肿热毒炽盛证患者大肠埃希菌的耐药特点,为临床合理用药提供依据.方法:选取2025年7月至2026年1月郑州市大肠肛门病医院收治的108例肛周脓肿患者热毒炽盛证患者作为研究对象.采集患者脓液样本进行病原菌分离、鉴定及药敏试验,并对分离出的大肠埃希菌进行耐药基因检测,统计分析该类患者病原菌分布及大肠埃希菌耐药特点.结果:108例患者脓液细菌培养阳性97例(89.81%);阳性样本中共检出细菌99株,其中大肠埃希菌60株(60.61%),肺炎克雷伯菌27株(27.27%),奇异变形杆菌6株(6.06%),解鸟氨酸克雷伯菌2株(2.02%),产酸克雷伯菌1株(1.01%),聚团肠杆菌1株(1.01%),金黄色葡萄球菌1株(1.01%),表皮葡萄球菌1株(1.01%).大肠埃希菌为主要致病菌,对其进一步开展药敏试验及耐药基因检测显示:该菌对氨苄西林(78.33%)、复方新诺明(56.67%)、头孢唑林(43.33%)、头孢呋辛(38.33%)、头孢曲松(33.33%)、环丙沙星(33.33%)、左氧氟沙星(31.67%)、庆大霉素(26.67%)的耐药率较高;耐药基因检出情况为:gyrA 基因检出率 98.33%(59/60),gyrB 基因检出率 96.67%(58/60),parC 基因检出率 6.67%(4/60),TEM 基因检出率61.67%(37/60),VIM基因检出率1.67%(1/60).结论:肛周脓肿热毒炽盛证患者的主要致病菌为大肠埃希菌,该菌对多种常用抗菌药物存在较高耐药性,临床治疗可首选含酶抑制剂的复合制剂或碳青霉烯类抗菌药物.
Objective To analyze the drug resistance characteristics of Escherichia coli in patients with perianal abscess of heat-toxin exuberance syndrome,and to provide a basis for rational clinical medication.Methods A total of 108 patients with perianal abscess of heat-toxin exuberance syndrome admitted to Zhengzhou Hospital of Coloproctological Diseases from July 2025 to January 2026 were enrolled as the research objects.Pus samples were collected from patients for pathogen isolation,identification and drug sensitivity test,and drug resistance gene detection was performed on the isolated Escherichia coli.The pathogen distribution and drug resistance characteristics of Escherichia coli in such patients were statistically analyzed.Results Among the 108 pus samples,97 were positive for bacterial culture(89.81%).A total of 99 bacterial strains were detected in the positive samples,including 60 strains of Escherichia coli(60.61%),27 strains of Klebsiella pneumoniae(27.27%),6 strains of Proteus mirabilis(6.06%),2 strains of Klebsiella ornithinolytica(2.02%),1 strain of Klebsiella oxytoca(1.01%),1 strain of Enterobacter agglomerans(1.01%),1 strain of Staphylococcus aureus(1.01%),and 1 strain of Staphylococcus epidermidis(1.01%).Escherichia coli was the main patho-genic bacterium.Further drug sensitivity test and drug resistance gene detection showed that the bacterium had high drug resistance rates to ampicillin(78.33%),trimethoprim-sulfamethoxazole(56.67%),cefazolin(43.33%),cefuroxime(38.33%),ceftriaxone(33.33%),ciprofloxacin(33.33%),levofloxacin(31.67%),and gentamicin(26.67%).The detection rates of drug resistance genes were as follows:98.33%(59/60)for the gyrA gene,96.67%(58/60)for the gyrB gene,6.67%(4/60)for the parC gene,61.67%(37/60)for the TEM gene,and 1.67%(1/60)for the VIM gene.Conclusion The main pathogenic bacterium in patients with perianal abscess of heat-toxin exuberance syndrome is Escherichia coli,which has high drug resis-tance to a variety of commonly used antibiotics.Enzyme inhibitor-containing compound preparations or carbap-enem antibiotics can be preferred for clinical treatment.
郝瑞贞;李素勤;潘振豫;胡影影
郑州市大肠肛门病医院(河南 郑州 450004)郑州市大肠肛门病医院(河南 郑州 450004)郑州市大肠肛门病医院(河南 郑州 450004)郑州市大肠肛门病医院(河南 郑州 450004)
肛周脓肿热毒炽盛大肠埃希菌耐药性分析耐药基因
Perianal abscessHeat-toxin exuberance syndromeEscherichia coliDrug resistance analysisDrug resistance gene
《中国肛肠病杂志》 2026 (5)
46-49,4
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