胆道感染患者胆汁病原菌分布及耐药性分析

发布时间：2018-03-30 06:51

本文选题：胆道感染　切入点：胆汁培养　出处：《中华医院感染学杂志》2014年14期

【摘要】：目的调查分析胆道感染患者胆汁培养检出的201株病原菌种类及耐药性,为临床医师选择抗菌药物治疗提供实验室参考依据。方法调查2010年1月-2012年12月就诊的胆道感染患者临床资料,行胆道手术无菌留取胆汁标本进行培养和细菌的鉴定。结果胆道感染患者送检的312份胆汁标本中培养出201株病原菌,阳性检出率为64.4%;革兰阴性杆菌占66.2%、革兰阳性球菌占24.4%、真菌9.4%,检出第1位是大肠埃希菌91株占45.3%,检出第3位是粪肠球菌31株占15.4%;肠杆菌科细菌对碳青霉烯类、粪肠球菌对糖肽类抗菌药物100.0%敏感;革兰阴性杆菌耐药率40.0%的药物有磺胺甲VA唑/甲氧苄啶、庆大霉素、头孢噻肟、左氧氟沙星、环丙沙星,耐药率20.0%药物主要有阿米卡星、亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦,产超广谱β-内酰胺酶(ESBLs)细菌检出率为42.5%。结论胆道感染病原菌多源于肠道菌群,且病原菌的耐药性处于上升状态,医院应加强执行《抗菌药物临床应用管理办法》,提高医师合理用药理念,改变细菌耐药性快速上升的不良态势。
[Abstract]:Objective to investigate 201 strains of pathogenic bacteria detected in bile culture of patients with biliary tract infection and their drug resistance. Methods the clinical data of patients with biliary tract infection from January 2010 to December 2012 were investigated. Results 201 strains of pathogenic bacteria were cultured in 312 bile samples from patients with biliary tract infection. The positive rate was 64.4%; Gram-negative bacilli accounted for 66.2%, Gram-positive cocci 24.4%, fungi 9.4.The first detected was Escherichia coli 91 strains, 45.3%, and the third was Enterococcus faecalis 31 strains 15.40.Enterobacteriaceae was responsible for carbapenem. Enterococcus faecalis was sensitive to glycopeptide antibiotics 100.0%, Gram-negative bacilli resistance rate was 40.0%: sulfamethazol / trimethoprim, gentamicin, cefotaxime, levofloxacin, ciprofloxacin, drug resistance rate 20.0%. The positive rate of imipenem, meropenem, cefoperazone / sulbactam, piperacillin / tazobactam, extended-spectrum 尾 -lactamase producing ESBLswas 42.5%. And the drug resistance of pathogenic bacteria is on the rise, hospital should strengthen to carry out the management method of clinical application of antimicrobial agents, improve the concept of rational use of medicine by doctors, and change the bad situation of the rapid increase of bacterial resistance.
【作者单位】：利川市人民医院检验科;
【基金】：湖北省卫生厅基金资助项目(WJ01564)
【分类号】：R446.5

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