胆道感染病原菌分布与耐药性分析

发布时间：2018-03-07 16:34

本文选题：胆道感染　切入点：病原菌　出处：《中华医院感染学杂志》2015年17期 　论文类型：期刊论文

【摘要】：目的研究胆道感染病原菌分布及其耐药性,为临床医师合理用药提供实验室依据。方法对医院2013年1月-2014年2月经内镜逆行性胰胆管造影术(ERCP)术中所取胆汁标本219份进行培养,使用VITEK-2Compact仪器进行细菌鉴定和药敏试验;采用WHONET5.4软件统计药物敏感率。结果 219份胆汁标本共培养出病原菌147株,其中革兰阴性菌109株占74.1%,以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主,革兰阳性菌30株占20.4%,以屎肠球菌和粪肠球菌为主,真菌8株占5.5%;大肠埃希菌对碳青霉烯类高度敏感,无耐药发生,对哌拉西林、头孢曲松、头孢唑林的耐药率最高,均为98.3%;肺炎克雷伯菌对碳青霉烯类、哌拉西林/他唑巴坦、头孢替坦高度敏感,无耐药发生,对哌拉西林、氨苄西林的耐药率最高,均为100.0%;铜绿假单胞菌对阿米卡星高度敏感,无耐药发生,对磺胺甲VA唑/甲氧苄啶、头孢曲松、头孢唑林、氨苄西林/舒巴坦、呋喃妥因、氨苄西林、头孢替坦的耐药率最高,均为100.0%;屎肠球菌和粪肠球菌均对替加环素高度敏感,无耐药发生,对克林霉素、红霉素的耐药率最高,均为100.0%。结论胆道感染不同病原菌耐药性差异较大,临床医师在经验用药的同时应尽快送检进行病原学检测,根据药敏结果合理使用抗菌药物。
[Abstract]:Objective to study the distribution of pathogenic bacteria and their drug resistance in biliary tract infection, and to provide laboratory basis for rational use of drugs. Methods from January 2013 to 2014, 219 samples of bile were collected during endoscopic retrograde cholangiopancreatography (ERCP) from January 2013 to 2014 in the hospital. Results A total of 147 strains of pathogenic bacteria were cultured in 219 bile samples, of which 109 strains were Gram-negative bacteria (74.1%). Klebsiella pneumoniae and Pseudomonas aeruginosa accounted for the majority, Gram-positive bacteria accounted for 20.4, Enterococcus faecium and Enterococcus faecalis mainly, fungi 8 strains accounted for 5.5.The Escherichia coli was highly sensitive to carbapenems and had no drug resistance, and was resistant to piperacillin and ceftriaxone. Klebsiella pneumoniae was highly sensitive to carbapenem, piperacillin / tazobactam, ceftitan, and had no resistance to ceftitan, and had the highest resistance to piperacillin and ampicillin. Pseudomonas aeruginosa was highly sensitive to amikacin and had no resistance to amikacin, and had the highest resistance to sulfamethoxazole / trimethoprim, ceftriaxone, cefazolin, ampicillin / sulbactam, furantoin, ampicillin and ceftitan. Both Enterococcus faecium and Enterococcus faecalis were highly sensitive to tegacycline and had no resistance to tegicycline. The drug resistance rates of clindamycin and erythromycin were the highest, which were both 100.0.Conclusion the drug resistance of different pathogens in biliary tract infection is different. The clinicians should be sent to the etiology test as soon as possible to use antibiotics reasonably according to the results of drug sensitivity.
【作者单位】：解放军第451医院检验科;
【基金】：陕西省科技攻关基金资助项目(2012K06-31)
【分类号】：R575.6;R446.5

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