胆囊炎和胆管炎患者胆汁分离菌的细菌学特征及药敏分析

发布时间：2018-07-21 16:17

【摘要】：目的分析胆囊炎及胆管炎患者胆汁中致病菌的特征及药物过敏情况,以便为此后的实际临床研究提供更多的参考依据。方法收集2015年10月—2016年10月该院收治的472例胆囊炎及胆管炎患者的胆汁标本,进行细菌培养,并利用全自动微生物系统鉴定致病菌的特征及药敏情况。结果胆汁标本共分离出311株非重复细菌,其中真菌占据3.2%;由粪肠球菌及屎肠球菌引起的革兰阳性细菌占据32.5%;由大肠埃希菌及肺炎克雷伯菌引起的格兰阴性细菌占据64.3%。且这些致病菌的药敏情况为:大肠埃希菌对替加环素、阿米卡星、头孢替坦以及头孢他啶等抗生素的敏感率在80.0%以上;肺炎克雷伯菌对环丙沙星及左氧氟沙星的敏感度分别为76.5%与80.0%。在肺炎克雷伯菌及阴沟肠杆菌中检测出了碳青霉烯菌的耐药株,且替加环素与万古霉素等抗生素对粪肠球菌及屎肠球菌的体外活性较强。结论革兰阴性细菌是胆道分离菌中的主要组成部分,尤其在大肠中最为常见,且可以利用头孢菌素治疗革兰阴性菌,利用替考拉宁药物治疗革兰阳性细菌。
[Abstract]:Objective to analyze the characteristics of bile pathogenic bacteria and drug allergy in patients with cholecystitis and cholangitis. Methods the bile samples of 472 patients with cholecystitis and cholangitis were collected from October 2015 to October 2016. Results 311 strains of non-repetitive bacteria were isolated from bile samples, of which fungi occupied 3.2%; Gram-positive bacteria caused by Enterococcus faecalis and Enterococcus faecium accounted for 32.5%; Gran negative bacteria caused by Escherichia coli and Klebsiella pneumoniae accounted for 64.3%. The susceptibility of Escherichia coli to tegacyclin, amikacin, ceftitan and ceftazidime was over 80.0%. The sensitivity of Klebsiella pneumoniae to ciprofloxacin and levofloxacin were 76. 5% and 80. 0%, respectively. The resistant strains of carbapenem were detected in Klebsiella pneumoniae and Enterobacter cloacae, and tegicycline and vancomycin had strong activity against Enterococcus faecalis and Enterococcus faecium in vitro. Conclusion Gram-negative bacteria are the main components of biliary tract isolates, especially in large intestine. Cephalosporins can be used to treat Gram-negative bacteria and teicoplanin to treat Gram-positive bacteria.
【作者单位】：黑龙江省双鸭山市人民医院检验科;
【分类号】：R446.5;R575.6

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