胆道感染患者胆汁病原菌培养及药敏分析  

Bacterial Culture and Antibiotics Sensitivity of Pathogens Isolated from Patients with Biliary Tract Infection

作　　者：杨亚敏[1] 阚志超[1] 张富玉[1] 龙莉[1] 

机构地区：[1]天津市第三中心医院感染管理科天津市人工细胞重点实验室,天津300170

出　　处：《中华医院感染学杂志》2010年第21期3427-3429,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析胆道感染患者的胆汁中病原菌分布及药敏情况,为临床合理使用抗菌药物提供参考。方法对162份胆道感染患者的胆汁标本进行病原菌培养和药敏试验。结果 162份胆汁标本中56份检出病原菌,阳性率为34.57%,其中2例为混合感染菌;共检出58株病原菌,其中大肠埃希菌35株,占60.34%,其中ESBLs大肠埃希菌6株,占17.14%;肺炎克雷伯菌5株,占8.62%,屎肠球菌4株,占6.90%;32份胆汁标本同时送厌氧菌培养,检出率为0;革兰阴性菌对亚胺培南、美罗培南、阿米卡星的敏感率均>90.00%;β-内酰胺类加酶抑制剂和奈替米星,敏感率均>80.00%;对青霉素类、头孢菌素类、喹诺酮类的敏感率较低;革兰阳性菌对替考拉宁、万古霉素、利奈唑胺、米诺环素的敏感率为100.00%;对喹奴普汀/达福普汀、利福平的敏感率为88.89%,对大环内酯类、呋喃妥因、氨基糖苷类、喹诺酮类的敏感率较低。结论胆道感染以大肠埃希菌为主,临床应跟据药敏结果合理选择抗菌药物。OBJECTIVE To analyze the distribution of pathogens and antibiotics sensitivity in patients with biliary tract infection, and to provide reference for reasonable application of antibiotics in clinics. METHODS Totally 162 bile samples were collected for bacterial cultures and drug sensitivity test. RESULTS Of the total 162 bile samples, pathogens were found in 56 samples, the positive rate was 34. 57% , of which, 2 were with mixed infection. Totally 58 pathogens were found, of which 35 strains were Escherichia coli （60.34%）, 6 ESBLs-producing E. coli strains （17. 14%）, 5 strains Klebsiella pneumoniae strains （8. 62%） and 4 strains Enterococcus faecium strains （6.90%）. Thirty-two samples were detected anaerobic bacteria also, of which there was no anaerobic. Drug sensitivity results showed that the susceptibility rates of Gram-negative bacteria to imipenem, meropenem and amikacin were over 90.00%, to enzyme inhibitors and netilmicin over 80.00%; but resistant to penicillins, cephalosporins and quinolones. The susceptibility rates of Gram-positive bacteria to teicoplanin, vancomycin, linezolid and minocycline were 100. 00%, to quinutristin/dalfopristin, and rifampicin were 88. 89%, but to macrolides, nitrofurantoin, aminoglycosides and quinolones were low. CONCLUSION E. coli is the main pathogen in biliary tract infection. Rational application of antibiotics in clinics should be made on the basis of the results of drug sensitivity test.

关 键 词：胆汁 病原菌 药敏试验 

分 类 号：R378[医药卫生—病原生物学]