Pathogen distribution and drug resistance in patients with Fournier’s gangrene

Zhang Jiayuan; Lu Jingen; Wang Qiantao; Wang Chen; Yao Yibo

doi:10.13406/j.cnki.cyxb.003726

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Pathogen distribution and drug resistance in patients with Fournier’s gangrene

Clinical research | 更新时间：2026-02-13

- Pathogen distribution and drug resistance in patients with Fournier’s gangrene
- Journal of Chongqing Medical University Vol. 51, Issue 1, Pages: 109-114(2026)
- 作者机构：
  
  1.上海中医药大学附属龙华医院肛肠科，上海 200032
  2.上海市第六人民医院中医科，上海 200032
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003726
  CLC： R657.1
- Received：26 July 2024，
  
  Revised：2024-11-14，
  
  Published：28 January 2026
- 稿件说明：
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张嘉员,陆金根,王钱陶等.肛周会阴部坏死性筋膜炎病原菌分布及耐药性分析[J].重庆医科大学学报,2026,51(01):109-114.

Zhang Jiayuan,Lu Jingen,Wang Qiantao,et al.Pathogen distribution and drug resistance in patients with Fournier’s gangrene[J].Journal of Chongqing Medical University,2026,51(01):109-114.
张嘉员,陆金根,王钱陶等.肛周会阴部坏死性筋膜炎病原菌分布及耐药性分析[J].重庆医科大学学报,2026,51(01):109-114. DOI： 10.13406/j.cnki.cyxb.003726.

Zhang Jiayuan,Lu Jingen,Wang Qiantao,et al.Pathogen distribution and drug resistance in patients with Fournier’s gangrene[J].Journal of Chongqing Medical University,2026,51(01):109-114. DOI： 10.13406/j.cnki.cyxb.003726.

摘要

目的

分析肛周会阴部坏死性筋膜炎患者致病菌分布及其药敏试验结果，为重症感染性疾病合理使用抗生素方案提供依据。

方法

回顾性分析2015年1月至2022年6月上海中医药大学附属龙华医院肛肠科收治肛周会阴部坏死性筋膜炎患者64例，统计患者的临床资料、病原菌培养结果和药敏试验结果。

结果

64例微生物送检报告中，未见病原菌生长12例，病原菌生长52例，共培养出79株致病菌。致病菌以革兰阴性菌为主，2种优势菌为大肠埃希菌（25/79，31.65%）和肺炎克雷伯菌（22/79，27.85%）。药敏试验结果显示，革兰阳性菌对青霉素G耐药率高达78.57%，对万古霉素敏感率为100%；革兰阴性菌对氨苄西林、头孢曲松、复方新诺明、左氧氟沙星、氨苄西林-舒巴坦的耐药率高于50%，对亚胺培南、美罗培南和阿米卡星的敏感性较高。分析病原菌种类与死亡率、住院时间和Fournier坏疽严重程度指数（Fournier’s gangrene severity index，FGSI）的相关性，发现混合菌组比革兰阴性菌组住院时间增加4.287 d，但病原菌种类与死亡率和FGSI评分无相关性。

结论

肛周会阴部坏死性筋膜炎感染以革兰阴性菌为主，早期足量使用碳青霉烯类、糖肽类联合硝基咪唑类抗生素可以达到更高的病原菌覆盖率。病原菌对常见抗生素的敏感性较低，耐药菌株种类和数量较以往报道有所增加，临床上应规范抗菌药物的使用，降低耐药菌株产生。

Abstract

Objective

To investigate the distribution of pathogens and the results of drug sensitivity test in patients with Fournier’s gangrene（FG），and to provide a basis for rational use of antibiotics in the treatment of severe infectious diseases.

Methods

A retrospective analysis was performed for the data of 64 patients with FG who were admitted to Department of Anorectal Surgery，Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine，from January 2015 to June 2022，including clinical data and the results of bacterial culture and drug sensitivity test.

Results

Among the 64 microbial test reports，there were 12 cases without pathogen growth and 52 cases with pathogen growth，and a total of 79 pathogenic strains were isolated. Most pathogenic bacteria were Gram-negative bacteria，with two dominant bacteria of

Escherichia coli

（25/79，31.65%） and

Klebsiella pneumoniae

（22/79，27.85%）. The results of drug sensitivity test showed that the resistance rate of Gram-positive bacteria to penicillin G reached as high as 78.57%，with a sensitivity rate of 100% to vancomycin； Gram-negative bacteria had a resistance rate of

50% to ampicillin，ceftriaxone，sulfamethoxazole-trimethoprim，levofloxacin，and ampicillin-sulbactam，with a relatively high sensitivity to imipenem，meropenem，and amikacin. By analyzing the correlation of the types of pathogens with mortality rate，length of hospital stay，and Fournier’s Gangrene Severity Index（FGSI） score，it was found that the length of hospital stay in the mixed bacterial infection group was 4.287

days longer than that in the Gram-negative bacterial infection group，while the types of pathogens were not correlated with mortality rate or FGSI score.

Conclusion

FG is mainly caused by Gram-negative bacteria，and early and sufficient use of carbapenems，glycopeptides，and nitroimidazoles can achieve a higher coverage rate of pathogenic bacteria. Pathogenic bacteria tend to have a low sensitivity to common antibiotics，and there are increases in the types and numbers of drug-resistant strains compared with previous reports，suggesting that the use of antibiotics should be standardized in clinical practice to reduce the production of drug-resistant strains.

关键词

Keywords

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