目的:关于与肛门直肠脓肿相关的病原微生物的数据有限。目的回顾性分析肛肠脓肿患者脓液培养中病原微生物的种类和数量,探讨病原微生物与肛肠脓肿种类的相关性。
方法:对2017年1月至2021年12月在单中心治疗的517例肛肠脓肿住院手术患者的微生物学数据进行回顾性分析。采用卡方检验分析不同类型肛肠脓肿间病原微生物种类和数量是否存在差异。
结果:在517名患者中,平均年龄为38.5岁,平均病程为7.4天。其中,男性440人(85.1%),女性77人(14.9%)。肛门直肠脓肿的类型包括肛周脓肿(54例,10.4%),括约肌间脓肿(253例,48.9%),坐骨直肠脓肿(129例,25.0%),肛后深(DPAS)脓肿(26例,5.0%),提上肌脓肿(10例,1.9%),和马蹄形脓肿(45例,8.7%)。从517个脓液标本中培养了总共23种不同的微生物。最常见的微生物是大肠杆菌(323例,62.5%),其次是肺炎克雷伯菌(77例,14.9%),脆弱拟杆菌(9例,1.7%),铜绿假单胞菌(8例,1.5%),和金黄色葡萄球菌(7例,1.4%)。此外,58例(11.2%)脓液标本中无微生物培养。9例(1.7%)合并坏死性筋膜炎。在9例并发坏死性筋膜炎中,大肠杆菌,肺炎克雷伯菌,金黄色葡萄球菌培养6例(66.7%),两个(22.2%),和一例(11.1%),分别。卡方检验显示不同类型肛肠脓肿间病原微生物种类和数量差异无统计学意义(P>0.05)。
结论:本研究提供了来自肛门直肠脓肿患者的大量脓液培养微生物学数据样本。无论是单纯的肛门直肠脓肿还是并发坏死性筋膜炎,大肠埃希菌是从肛门直肠脓肿患者脓液中培养出来的最常见的微生物。其他常见的微生物包括肺炎克雷伯菌,B.脆弱,和金黄色葡萄球菌。这些结果为精确的抗生素治疗肛门直肠脓肿提供了证据。此外,不同类型肛肠脓肿的病原微生物种类和数量无差异。
OBJECTIVE: There is limited data on the pathogenic microorganisms associated with anorectal abscesses. The purpose of this study was to retrospectively analyze the types and quantities of pathogenic microorganisms in the pus cultures of patients with anorectal abscesses and to explore the correlation between pathogenic microorganisms and types of anorectal abscesses.
METHODS: A retrospective analysis was conducted on the microbiological data of 517 inpatient surgical patients with anorectal abscesses treated at a single center from January 2017 to December 2021. Chi-square tests were used to analyze whether there were differences in the types and quantities of pathogenic microorganisms among different types of anorectal abscesses.
RESULTS: Among the 517 patients, the mean age was 38.5 years, with an average duration of illness of 7.4 days. Of these, 440 (85.1%) were male and 77 (14.9%) were female. The types of anorectal abscesses included perianal abscesses (54 cases, 10.4%), intersphincteric abscesses (253 cases, 48.9%), ischiorectal abscesses (129 cases, 25.0%), deep posterior anal space (DPAS) abscesses (26 cases, 5.0%), supra-levator abscesses (10 cases, 1.9%), and horseshoe abscesses (45 cases, 8.7%). A total of 23 different microorganisms were cultured from the 517 pus specimens. The most common microorganism was Escherichia coli (323 cases, 62.5%), followed by Klebsiella pneumoniae (77 cases, 14.9%), Bacteroides fragilis (nine cases, 1.7%), Pseudomonas aeruginosa (eight cases, 1.5%), and Staphylococcus aureus (seven cases, 1.4%). Additionally, no microorganisms were cultured from 58 (11.2%) pus specimens. Nine patients (1.7%) were admitted with concomitant necrotizing fasciitis. Among the nine cases of concurrent necrotizing fasciitis, E. coli, K. pneumoniae, and S. aureus were cultured in six (66.7%), two (22.2%), and one (11.1%) case, respectively. Chi-square tests revealed no significant differences in the types and quantities of pathogenic microorganisms among different types of anorectal abscesses (P > 0.05).
CONCLUSIONS: This study provides a large sample of pus culture microbiological data from patients with anorectal abscesses. Regardless of whether it is a simple anorectal abscess or concurrent necrotizing fasciitis, E. coli was the most common microorganism cultured from the pus of patients with anorectal abscesses. Other common microorganisms include K. pneumoniae, B. fragilis, and S. aureus. These results provide evidence for the precise antibiotic treatment of anorectal abscesses. Additionally, there were no differences in the types and quantities of pathogenic microorganisms among different types of anorectal abscesses.