急性梗阻化脓性胆管炎病原菌及药敏分析  

Drug susceptibility analysis of major pathogens for acute obstructive suppurative cholangitis

作　　者：高虎云[1] 陈加[1] 汪平凡[1] 张永萍[1] 

机构地区：[1]浙江省新昌县人民医院消化内科,浙江新昌县312500

出　　处：《中华医院感染学杂志》2014年第7期1606-1607,1616,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医学会临床科研基金项目(2009ZYC40)

摘　　要：目的了解急性梗阻化脓性胆管炎病原菌菌种及其耐药性,为治疗该病经验性抗菌药物选用提供指导。方法收集2010年1月1日-2012年11月31日急性梗阻化脓性胆管炎85例,均未用抗菌药物,入院后急诊行ERCP术引流获取的胆汁送检培养和药敏试验,采用SPSS11.5软件进行统计分析。结果在85例患者中分离105株病原菌,其中革兰阴性菌67株占63.81%,革兰阳性菌35株占33.33%,真菌属3株占2.86%;引起胆道感染常见的病原菌依次为大肠埃希菌、粪肠球菌、屎肠球菌及肺炎克雷伯菌,分别占39.97%、13.31%、10.46%及7.63%;革兰阴性菌对阿米卡星和亚胺培南耐药率最低,耐药率为0;革兰阳性菌对万古霉素和氯霉素耐药最低,耐药率为0。结论急性梗阻化脓性胆管炎中的革兰阴性菌占主要地位,但革兰阳性菌也占有较大比重,常用的三代头孢菌素有较高的耐药,对急性梗阻化脓性胆管炎建议首选亚胺培南联合万古霉素抗感染治疗。OBJECTIVE To investigate the distribution and drug susceptibility of major pathogens for acute obstruc-tive suppurative cholangitis ,in order to give an instruction to adoption of antibiotics .METHODS A total of 85 cases of acute obstructive suppurative cholangitis in our hospital from Jan .2010 to Nov .2012 were collected . Antibiotics were not used before hospitalization .After admitted ,the ERCP was to get bile ,and which was cul-tured routinely and performed susceptibility test . The SPSS 11 .5 software was used for statistic analysis . RESULTS A total of 105 strains of pathogens were isolated from 85 cases .which included 67 gram-negative strains （63 .81% ） ,35 gram-positive strains （33 .33% ） ,3 fungi （2 .86% ） .Pathogens of acute obstructive suppurative cholangitis were ih turns Escherichia coli （39 .97% ） , Enterococcus f aecalis （13 .31% ） , Enterococcus f aecium （10 .46% ） ,K lebsiella pneumoniae （7 .63% ） .The results of drug susceptibility showed that the drug resistance rates of gram-negative strains to amikacin and imipenem were the lowest and the drug resistance rate was 0;the drug resistance rates of gram-positive strains to vancomycin were the lowest ,which was 0 .CONCLUSION Gram-negative strains is the main cause of acute obstructive suppurative cholangitis infections ,but gram-positive strains also have large quantity .The resistant rates of gram positive strains to the third generation cephalosporins are high .Imipenem with Vancomycin are chiefly choosed to control acute obstructive suppurative cholangitis infec-tions .

关 键 词：急性梗阻化脓性胆管炎 胆汁培养 病原菌 药物敏感性 

分 类 号：R378[医药卫生—病原生物学]