急性闌尾炎細菌學：308例報告

Bacteriology of Acute Appendicitis: Report of 308 Cases

鄧允武(Yun-Wu Deng) ； 藍秉文(Ping-Man Lam) ； 彭芝玲(Chei-Ling Peng) ； 林保成(Baa-Cherng Lin)

《台灣急診專科醫師期刊》 5卷1期 (2013/03) Pp. 1-4

摘要

目的：調查急性闌尾炎病患細菌培養結果，做為抗生素治療參考。方法：回朔性撿視308例有細菌培養的急性闌尾炎病歷並紀錄菌種。結果：149例核測腹水或傷口的細菌培養，陽性平83.9%，前五名菌種為大腸桿菌、類桿菌、鏈球茵、假單胞菌、克雷白氏菌；236例檢測血液培養，陽性率為16.1%，前五名菌種與腹水或傷口培養相同；腹水或傷口培養出來的細菌以革蘭陰性菌最多為96.8%，合併感染兩種以上屬性菌種者佔68.0%。結論:腹水或傷口細菌培養之陽性率高，有大於2/3的病人主現兩種以上屬性的細菌，因此應使用至少能治療格蘭陰性菌與厭氧菌的抗生素。

關鍵字

闌尾炎 ； 細菌 ； 感染 ； 抗生素

並列摘要

Objective: Investigate the results of bacterial cultures from patients with appendicitis to aid in the choice of antibiotics. Methods: Retrospectively examine bacterial cultures from 308 cases of pathologically proved appendicitis and record the bacterial species. Results: Peritoneal/wound cultures showed positive results in 83.9% of 149 patients. Blood cultures showed positive results in 16.1% of 236 patients. The five most common bacterial species in both blood and peritoneal/wound cultures were E coli, Bacteroides sp., Streptococci, Pseudomonas sp., and Klebsiella sp. Gram-negative bacteria were the most common. Sixty eight percent of patients had mixed types of bacteria. Conclusion: Bacteria were cultured in a high percentage of peritoneal/wound cultures. More than two-third of patients has two or more types of bacteria. Empiric antibiotics should cover Gram-negative and anaerobic bacteria.

並列關鍵字

appendicitis ； bacteria ； infection ； antibiotics