中文摘要：

目的分析慢性肝病患者胸腔积液标本中病原菌种类及其耐药情况。方法对浙江省东阳市中医院247例慢性肝病患者送检的胸腔积液标本进行分离培养、鉴定及药敏试验，观察胸腔积液标本中病原菌分布及各种病原菌耐药情况。结果①从247份胸腔积液标本中分离出病原菌213株，阳性检出率为86．2％，其中，50．2％为革兰阳性菌（G＋），44．6％为革兰阴性菌（G-），5．2％为真菌。②G＋对青霉素、复方新诺明、红霉素的耐药率比较高，对利奈唑胺、替考拉宁、万古霉素的耐药率极低。G-对阿莫西林、庆大霉素、四环素的耐药率较高。其中，产ESBL的大肠埃希菌对美罗培南、亚胺培南敏感，对其他抗菌药物耐药率均较高。结论临床治疗中，应尽早进行胸腔积液常规细菌培养和药物敏感性试验，并根据试验结果合理使用抗菌药物。对于G＋万古霉素和替考拉宁仍然是目前最有效药物。对于G-美罗培南、亚胺培南是较为有效的药物。

英文摘要：

Objective To analyze the pathogens species and drug resistance of pleural effusion specimens in patients with chronic liver disease. Methods Pleural effusion specimens of 247 patients with chronic liver disease in Hospital of Traditional Chinese Medicine in Dongyang City were collected. Then all the specimens were given isolated and cultured, identification and susceptibility testing. Pathogen distribution and drug resistance of pleural effusion specimens were observed. Results ① 213 strains of pathogens were isolated from 247 pleural effusion specimens, the positive rate was 86.2%, in which there were 50.2% of Gram-positive bacteria （G＋）, 44.6% of Gram-negative bacteria （G-） , 5.2% of fungi. ②The resistance rates of G＋ were relatively high to Penicillin, Cotrimoxazole, Erythromyein, and they were extremely low to Linezolid, Teicoplanin, Vancomycin. The resistance rates of G- were relatively high to Amoxicillin, Gentamicin, Tetracycline. ESBL-producing E.coli was sensitive to Meropenem, Imipenem, and had high resistance to other antimicrobial agents. Conclusion In clinical treat- ment, pleural effusion routine bacterial culture and drug susceptibility testing should be carried out as soon as possible, an- timicrobial drugs should be used according to the test results. Vancomyein and Teicoplanin are still the most effective drugs for G＋. Meropenem and Imipenem are more effective drugs for G-.