胆道感染病原菌分布与耐药性研究

发布时间：2018-12-19 19:26

【摘要】：目的了解胆道感染患者胆汁内分离的病原菌种类及其耐药性,为临床医师正确选择敏感抗菌药物提供参考依据。方法选取2010年1月-2014年12月医院收治的331例胆道感染患者,以无菌方式采集感染患者的胆汁标本,采用全自动微生物分析仪VITEK-2Compact进行菌株鉴定,药敏试验采用K-B法进行,药敏结果依据CLSI标准进行判读;采用WHONET 5.5-5.6软件对数据进行统计分析。结果 331例胆道感染患者胆汁标本中培养阳性134例,阳性检出率为40.5%;共分离出病原菌174株,其中革兰阴性菌112株占64.4%,革兰阳性菌47株占27.0%,真菌15株占8.6%;所有胆道感染菌对常用抗菌药物均产生了不同程度的耐药性,但大肠埃希菌和肺炎克雷伯菌对碳青霉烯类、粪肠球菌对糖肽类敏感率为100.0%;产ESBLs菌阳性检出率为48.9%,耐甲氧西林金黄色葡萄球菌阳性检出率为50.0%。结论胆道感染菌以肠道菌为主,其耐药率日渐增长,医院应增强用药管理的执行力,细化抗菌药物处方分级制度,以降低病原菌耐药性。
[Abstract]:Objective to investigate the types and drug resistance of pathogenic bacteria isolated from bile of patients with biliary tract infection, and to provide reference for clinicians to select sensitive antibiotics correctly. Methods from January 2010 to December 2014, the bile samples of 331 patients with biliary tract infection were collected in an aseptic manner, and the strains were identified by automatic microbiological analyzer (VITEK-2Compact). The drug sensitivity test was conducted by K-B method and the results were interpreted according to CLSI standard. The data were analyzed by WHONET 5.5-5.6 software. Results 134 out of 331 bile samples from patients with biliary tract infection were positive, the positive rate was 40.5%. 174 strains of pathogenic bacteria were isolated, of which 112 strains were Gram-negative bacteria (64.4%), 47 strains were Gram-positive bacteria (27.0%) and 15 strains were fungi (8.6%). All the bacteria of biliary tract infection had different drug resistance to common antimicrobial agents, but Escherichia coli and Klebsiella pneumoniae were sensitive to carbapenem and Enterococcus faecalis to glycopeptide. The positive rate of ESBLs producing bacteria and methicillin-resistant Staphylococcus aureus was 48.9 and 50.0 respectively. Conclusion the bacteria of biliary tract infection are mainly intestinal bacteria, and the drug resistance rate is increasing day by day. Hospitals should strengthen the execution of drug administration, refine the classification system of antimicrobial prescriptions, and reduce the drug resistance of pathogenic bacteria.
【作者单位】：湖北省监利县人民医院检验科;湖北省监利县人民医院手术室;
【基金】：湖北省卫生厅基金资助项目(WJ01564)
【分类号】：R446.5

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