关键词: 肝硬化, 腹膜炎, 细菌, 抗药性

Abstract: ObjectiveTo analyze pathogen distribution and drug resistance in liver cirrhosis patients with spontaneous bacterial peritonitis for the basis for clinical rational drug use. MethodsRetrospective analysis was made in the positive bacterial culture results of liver cirrhosis  patients（534 cases） with spontaneous bacterial peritonitis in our hospital. Depending on the kind of bacteria， we grouped the patients， and compared the percentage of each group of bacteria， at the same time for the dominant strains (Escherichia coli， Enterococcus feces)， we analyzed resistance rate. ResultsBacterial culture positive cases was 61 cases and  78 strains of pathogenic bacteria were isolated， in which 45 patients as a single infection(73.8%)，16 patients a composite infection(26.2%) and 15 cases of complex infection(93.8%). In 78 strains of bacteria， gramnegative bacteria were 40 strains(51.3%)， and Escherichia coli accounted for 37.5% of gramnegative bacteria; grampositive bacteria was 32(41.0%)，of which Enterococcus Faecium accounted for 59.4% of gramnegative bacteria， meanwhile the total number of Enterococcus Faecium(19) was more than Escherichia coli(15); Fungi was 6 strains，accounting for 7.7%. E. coli was highly resistant to ampicillin and levofloxacin，trimethoprimsulfamethoxazole，cefuroxime，respectively，accounted for 93.3%，80.0% and 73.3%. Enterococcus Faecium was highly resistant to Feces enterococci to ampicillin， penicillin， levofloxacin， norfloxacin， respectively，68.4%，63.2%，57.9% and 42.1%; Discovery of one case of vancomycinresistant strains was Enterococcus Faecium. No strains resistant to linezolid were discovered. ConclusionIn liver cirrhosis  patients with spontaneous bacterial peritonitis infected mainly in Enterococcus Faecium and Escherichia coli，the phenomenon of resistance has been very serious. Clinicians should be based on the type of pathogen and make reasonable choice for antibiotic use.

Key words: liver cirrhosis, peritonitis, bacterial, drug resistance