中文摘要：

目的研究急性重症胰腺炎（SAP）患者腹腔感染的病原菌分布及药敏性,为临床合理应用抗菌药物提供依据。方法选取2010年2月-2015年6月医院住院治疗的SAP患者160例作为研究对象,按是否发生腹腔感染将患者分为感染组82例和未感染组78例;对感染病原菌进行分离鉴定及药敏试验,分析试验结果,随访3个月,比较两组患者临床指标及病死率;采用SPSS17.0软件进行统计分析。结果感染组的Ranson评分及住院时间均显著大于未感染组,差异有统计学意义（P〈0.05）;160例SAP患者中,发生腹腔感染82例,感染率为51.25%;共检出病原菌90株,其中革兰阴性菌67株占74.45%,革兰阳性菌21株占23.33%,真菌2株占2.22%;主要革兰阴性菌对亚胺培南的敏感率最高,均为100.00%,其次为头孢哌酮/舒巴坦以及哌拉西林/舒巴坦,敏感率均≥75.00%,对氨苄西林的敏感率最低,均≤25.00%;主要革兰阳性菌对万古霉素、利奈唑胺和氨苄西林的敏感率较高,均≥83.33%,葡萄球菌属对青霉素的敏感率最低,为9.09%,而肠球菌属对替考拉宁的敏感率最低,为33.33%。结论导致SAP患者发生腹腔感染的病原菌主要为革兰阴性菌和革兰阳性菌,前者可考虑应用亚胺培南等药物治疗,后者则可考虑给予万古霉素等药物治疗。

英文摘要：

OBJECTIVE To investigate the distribution and drug susceptibility of pathogens causing abdominal infections in patients with severe acute pancreatitis（SAP）so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 160 SAP patients who were hospitalized from Feb 2010 to Jun 2015 were recruited as the study objects and divided into the infection group with 82 cases and the non-infection group with 78 cases according to the status of abdominal infections.The pathogens causing the infections were isolated and identified,the drug susceptibility testing was carried out,the results were analyzed,a three-month follow-up was conducted,the clinical indicators and mortality rates were observed and compared between the two groups of patients,and the statistical analysis was performed with the use of SPSS17.0software.RESULTS The Ranson score of the infection group was significant by higher than that of the non-infection group,and the length of hospital stay of the infection group was significantly longer than that of the non-infection group（P〈0.05）.The abdominal infections occurred in 82 of 160SAP patients,with the infection rate 51.25%.Totally 90 strains of pathogens were isolated,including67（74.45%）strains of gram-negative bacteria,21（23.33%）strains of gram-positive bacteria,and 2（2.22%）strains of fungi.The drug susceptibility rate of the main gram-negative bacteria to imipenem was the highest（100.00%）;the drug susceptibility rates to cefoperazone-sulbactam and piperacillin-sulbactam were no less than75.00%;the drug susceptibility rate to ampicillin was the lowest（no more than 25.00%）.The drug susceptibility rates of the main gram-positive bacteria to vancomycin,linezolid,and ampicillin were no less than 83.33%;the drug susceptibility rate of the Staphylococcus sppto penicillin was the lowest（9.09%）;however,the drug susceptibility rate of the Enterococcus sppto teicoplanin was the lowest（33.33%）.CONCLUSIONThe gram-negative bacteria and gram-positive bacteria