肝胆系统疾病患者胆汁病原菌分布与临床特征

发布时间：2019-04-01 11:45

【摘要】：目的了解肝胆系统疾病患者胆汁分离病原菌情况及临床特征。方法采用回顾性研究方法,收集和分析某院肝胆疾病患者胆汁标本细菌培养结果及相关临床资料。结果共收集肝胆系统疾病患者胆汁标本406份,培养阳性率为64.53%,262份阳性标本中分离单一病原菌的占62.21%(163份),2种病原菌的占32.83%(86份),3种病原菌的占4.96%(13份)。分离病原菌374株,其中革兰阴性菌242株(64.71%),革兰阳性菌131株(35.02%),真菌1株(0.27%)。肝硬化、既往有肝胆手术史、患胆道结石者胆汁分离病原菌阳性率均高于对照组(均P0.05),胆道系统不同部位结石患者的胆汁病原菌分离阳性率有差异;而不同年龄、性别、以及是否患肝胆肿瘤各组比较,差异均无统计学意义(均P0.05)。胆道系统有无结石、既往有无手术史患者胆汁分离病原菌种类构成比较,差异无统计学意义(均P0.05);而肝硬化患者与无肝硬化患者胆汁分离病原菌种类构成比较,差异有统计学意义(χ~2=14.058,P=0.001)。结论肝胆系统疾病患者胆汁分离菌以肠杆菌科细菌及肠球菌属细菌单一感染为主,肝胆系统结石患者、既往肝胆手术患者及肝硬化患者胆汁分离病原菌阳性率较高。
[Abstract]:Objective to investigate the pathogenic bacteria isolated from bile of patients with hepatobiliary diseases and its clinical characteristics. Methods the bacterial culture results and clinical data of bile samples from patients with hepatobiliary diseases in a hospital were collected and analyzed retrospectively. Results 406 bile samples from patients with hepatobiliary diseases were collected. The positive rate of culture was 64.53%. Among 262 positive samples, 62.21% (163 samples) were isolated from single pathogen and 32.83% (86 cases) were isolated from two kinds of pathogens. The three pathogens accounted for 4.96% (13 cases). 374 strains of pathogenic bacteria were isolated, of which 242 (64.71%) were Gram-negative, 131 (35.02%) Gram-positive and 1 (0.27%) fungal. The positive rate of pathogenic bacteria in bile separation in patients with hepatolithiasis and hepatolithiasis was higher than that in control group (P 0.05). The positive rate of bile pathogen isolation in patients with choledocholithiasis in different parts of the biliary system was significantly higher than that in the control group (P 0.05). There was no significant difference in age, sex and hepatobiliary tumor (P0.05). There was no significant difference in the composition of pathogenic bacteria in bile separation between patients with or without cholelithiasis and patients with or without surgical history (P 0.05). There was a significant difference in the types of pathogens isolated from bile between patients with cirrhosis and those without cirrhosis (蠂 ~ 2 / 14.058, P < 0.001). Conclusion the isolated bacteria in bile of patients with hepatobiliary diseases are mainly Enterobacteriaceae bacteria and Enterococcus single infection. The positive rate of bacteria isolated from bile of patients with hepatobiliary stone, patients undergoing hepatobiliary surgery and patients with liver cirrhosis is higher than that of patients with hepatobiliary diseases.
【作者单位】：湖南省人民医院湖南师范大学附属第一医院;
【基金】：2016年度湖南省卫生计生委科研计划项目(C2016009) 湖南省人民医院仁术基金(2016)
【分类号】：R575

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