胆结石患者胆道感染病原菌分布与药敏分析

发布时间：2018-06-13 13:17

本文选题：胆结石 + 胆道感染　；参考：《中华医院感染学杂志》2015年08期

【摘要】：目的分析胆结石合并胆道感染胆汁中病原菌的分布及药敏性,为临床合理用药提供参考。方法选取2009年3月-2014年3月收治的82例胆结石合并胆道感染患者,对患者利用内镜逆行胰胆管造影术进行检查,抽取胆汁样本进行病原菌的分布以及药敏分析,采用EpiData 3.1软件进行统计分析。结果 82例胆汁标本培养阳性的为78例,检出率为95.1%,共检出病原菌85株,其中革兰阴性菌59株占69.4%,革兰阳性菌18株占21.2%,真菌8株占9.4%;革兰阴性菌对亚胺培南的耐药率最低,其次为妥布霉素、哌拉西林/他唑巴坦、头孢吡肟及阿米卡星等,耐药率均30.0%;革兰阳性菌对万古霉素的耐药率最低,其次为庆大霉素、链霉素、环丙沙星、利福平等,耐药率均15.0%。结论胆结石合并胆道感染患者胆汁中病原菌的分布发生了新的变化,大肠埃希菌、肠球菌属及肺炎克雷伯菌等是其主要病原菌,在临床上,应根据患者胆汁药敏试验结果对抗菌药物进行合理选择。
[Abstract]:Objective to analyze the distribution and drug sensitivity of pathogenic bacteria in bile of cholelithiasis complicated with biliary tract infection. Methods 82 patients with cholelithiasis complicated with biliary tract infection were selected from March 2009 to March 2014. The patients were examined by endoscopic retrograde cholangiopancreatography. EpiData 3.1 software was used for statistical analysis. Results of the 82 bile samples, 78 were positive and the positive rate was 95.1. A total of 85 strains of pathogenic bacteria were detected, of which 59 were Gram-negative bacteria, 18 Gram-positive bacteria accounted for 21.2A, 8 fungi accounted for 9.40.Gram-negative bacteria had the lowest resistance to imipenem, and Gram-negative bacteria had the lowest resistance to imipenem. The next was tobramycin, piperacillin / tazobactam, cefepime and amikacin, the resistance rate of Gram-positive bacteria to vancomycin was the lowest, followed by gentamicin, streptomycin, ciprofloxacin and rifampicin. The drug resistance rates were 15.0%. Conclusion the distribution of pathogenic bacteria in bile of patients with cholelithiasis complicated with biliary tract infection has changed. Escherichia coli, Enterococcus and Klebsiella pneumoniae are the main pathogenic bacteria. The antimicrobial agents should be reasonably selected according to the results of bile susceptibility test.
【作者单位】：台州恩泽医疗中心(集团)路桥医院感染科;宁波大学医学院临床医学系;
【基金】：浙江省医药卫生科技基金资助项目(2011YCG147)
【分类号】：R446.5;R575.6

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