胆总管结石并发胆道感染患者病原菌与药敏分析

发布时间：2018-06-25 01:51

本文选题：胆总管结石 + 胆道感染　；参考：《中华医院感染学杂志》2015年17期

【摘要】：目的对胆总管结石伴胆道感染患者进行胆汁培养,对其病原菌分布及耐药性进行统计分析,为临床用药提供指导。方法选取医院2012年1月-2013年2月120例胆总管结石患者为研究对象,所有患者行内镜逆行胰胆管造影术(ERCP),术中抽取胆汁标本,进行细菌培养及药敏分析。结果 120例胆总管结石患者中96例检出病原菌,检出率为80.0%;共分离出病原菌107株,其中革兰阴性菌共检出75株占70.1%,革兰阳性菌30株占28.0%,真菌2株占1.9%;大肠埃希菌对亚胺培南、美罗培南及环丙沙星较敏感,耐药率20.0%,肺炎克雷伯菌和铜绿假单胞菌对亚胺培南、美罗培南高度敏感,耐药率均为0;粪肠球菌对万古霉素、磷霉素及氯霉素较为敏感,耐药率10.0%;真菌对酮康唑、伊曲康唑、制霉菌素及两性霉素较敏感。结论引起胆总管结石患者胆道感染的病原菌主要以革兰阴性菌为主,病原菌对常用抗菌药物表现出一定的耐药性,临床应根据药敏试验结果合理选用抗菌药物,避免盲目用药。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and drug resistance in bile culture of patients with choledocholithiasis and biliary tract infection in order to provide guidance for clinical use of drugs. Methods 120 patients with choledocholithiasis from January 2012 to February 2013 were studied. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Results among 120 patients with choledocholithiasis, 96 cases (80.0%) were found to have pathogenic bacteria, 107 strains were isolated, 75 strains were Gram-negative bacteria, 30 strains were Gram-positive bacteria, 28.0 strains were Gram-positive bacteria, and 2 strains were fungi. Mepenem and ciprofloxacin were sensitive, the drug resistance rate was 20.0. Klebsiella pneumoniae and Pseudomonas aeruginosa were highly sensitive to imipenem and meropenem, and the resistance rate was 0. Enterococcus faecalis was sensitive to vancomycin, fosfomycin and chloramphenicol. The resistance rate was 10.0. The fungi were sensitive to ketoconazole, itraconazole, nystatin and amphotericin. Conclusion Gram-negative bacteria are the main pathogens causing choledocholithiasis, and the pathogens are resistant to common antimicrobial agents. According to the results of antimicrobial susceptibility test, antimicrobial agents should be selected rationally in clinic to avoid blind use of antibiotics.
【作者单位】：瑞安市人民医院消化内科;
【基金】：浙江省医药卫生计划基金资助项目(2011KYA011)
【分类号】：R575.62;R446.5

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