梗阻性化脓性胆管炎患者病原菌分析  

Pathogens isolated from patients with obstructive suppurative cholangitis and clinical value

作　　者：戴文宇[1] 陈平[1] 吴枫[1] 

机构地区：[1]宁波市第二医院普外科,浙江宁波315010

出　　处：《中华医院感染学杂志》2013年第24期6147-6149,共3页Chinese Journal of Nosocomiology

基　　金：宁波市自然科学基金项目(2009A610179)

摘　　要：目的了解胆道感染主要病原菌种类及分布,分析药敏培养结果,为临床合理使用抗菌药提供参考依据。方法对632例急性胆道感染患者的胆汁进行细菌培养和药敏试验。结果从632例标本中检出病原菌632株,其中革兰阴性杆菌占52.8%,革兰阳性球菌占42.1%,革兰阴性杆菌中大肠埃希菌居首位占22.3%,革兰阳性菌中粪肠球菌居首位占15.9%;革兰阴性杆菌耐药性最低的是亚胺培南,氨苄西林和头孢唑林呈现较高的耐药率,革兰阳性球菌对万古霉素耐药率最低,其次为利奈唑胺。结论急性胆道感染多为革兰阴性菌感染,耐药谱复杂,临床上应加强胆汁细菌培养,以利于合理应用抗菌药物。OBJECTIVE To understand the distribution of major species of pathogens causing biliary tract infections and analyze the result of drug susceptibility testing so as to guide the reasonable clinical use of antibiotics. METHODS The bacterial culture was performed for the bile obtained from 632 cases of acute biliary tract infections, then the drug susceptibility testing was carried out. RESULTS Totally 632 strains of pathogens have been isolated from 632 specimens, among which the gram-negative bacilli accounted for 52.8%, and the gram-positive cocci accounted for 42.1% ; the Escherichia coli ranked the first place of the gram-negative bacilli, accounting for 22.3% the Enterococcus faecalis ranked the first place of the gram-positive cocci, accounting for 15.9%. The gram-negative bacilli were highly resistant to ampicillin and cefazolin, and the drug resistance rate to imipenem was the lowest; the drug resistance rate of the gram-positive cocci to vancomycin was the lowest, followed by linezolid. CONCLUSION The gram-negative bacteria are dominant among the pathogens causing acute biliary tract infections, with the drug resistance phenotype complex; it is necessary to perform the bacterial culture of bile so as to reasonably use antibiotics.

关 键 词：胆道感染 抗菌药物 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]