内镜逆行胰胆管造影术后感染的病原菌及耐药性分析  

Distribution and drug resistance of pathogens causing infections after endoscopic retrograde cholangiopancreatography

作　　者：张博[1] 张慧宇[1] 徐文思[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院消化一科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2014年第11期2647-2648,2651,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省教育厅研究基金项目(9232012Y1086)

摘　　要：目的研究内镜逆行胰胆管造影术后感染的病原菌种类分布,并对病原菌的耐药性进行分析,指导临床合理用药。方法选取医院2010年8月-2012年8月132例行内镜逆行胰胆管造影术后感染患者的标本,将分离培养的病原菌依据NCCLS指定的K-B琼脂法进行药敏试验,药敏试验结果判定严格按照按照NCCLS 2005年版。结果内镜逆行胰胆管造影术后感染患者病原菌来源分布中,胆汁38株占26.03%、胰液30株占20.55%、消化道23株占15.75%、尿液16株占10.96%;共分离出病原菌146株,其中革兰阳性菌64株占43.84%,革兰阴性菌82株占56.16%;革兰阳性菌对乙酰唑胺和林可霉素的耐药率较低,均<5.00%,革兰阴性菌对美罗培南和替考拉宁的耐药率较低,也均<5.00%。结论内镜逆行胰胆管造影术后感染患者病原菌对多数抗菌药物具有耐药性,当临床内镜逆行胰胆管造影术后感染发生时,应先分离培养病原菌,并进行药敏试验,选用耐药率低的抗菌药物进行及时的治疗。OBJECTIVE To study the distribution and drug resistance of pathogens causing infections after endoscopic retrograde cholangiopancreatography so as to provide guidance for reasonable clinical use of antibiotics. METHODS The specimens were collected from 132 patients with postoperative infections who underwent the endoscopic retrograde cholangiopancreatography in the hospital from Aug 2010 to Aug 2012, then the drug susceptibility testing for the isolated pathogens was performed with the use of K-B agar method specified by NCCLS, the result of the drug susceptibility testing was interpreted according to NCCLS 2005 edition. RESULTS Of the pathogens isolated from the specimens obtained from the patients undergoing the endoscopic retrograde eholangiopancreatography, 38 （26.03%） strains were isolated from bile, 30 （20.55%） strains from pancreatic juice, 23 （15.75%） strains from gastrointestinal tract, 16 （10.96%） strains from urine. A total of 146 strains of pathogens have been isolated, including 64 （43.84~） strains of gram-positive bacteria and 82 （56.16 %） strains of gram-negative bacteria. The drug resistance rates of the gram-positive bacteria to acetazolamide and lincomycin were less than 5.00% the drug resistance rates Of the gram-negative bacteria to meropenem and teicoplanin were less than 5. 00%. CONCLUSIONS The pathogens isolated from the patients with postoperative infections who undergo the endoscopic retrograde eholangiopancreatography are resistant to most of the antibiotics. Once the postoperative infections occur, it is necessary to isolate and culture pathogens, perform the drug susceptibility testing, and choose sensitive antibiotics for timely treatment.

关 键 词：内镜逆行胰胆管造影术 感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]