胆总管结石并胆道感染患者胆汁中致病菌的分布及耐药性分析  

Biliary Pathogenic Bacteria Distribution and Drug Resistance Analysis in Patients with Common Bile Duct Stones Combined Biliary Tract Infection

作　　者：吴海恩[1] 尹合坤[1] 李启祥[1] 区卫林[1] 陈莉君[1] 马艳环[1] 

机构地区：[1]广东省江门市中心医院消化内科,广东江门529030

出　　处：《现代生物医学进展》2014年第19期3672-3675,共4页Progress in Modern Biomedicine

基　　金：广东省产业技术研究与开发资金计划项目(2012A030400051)

摘　　要：目的:了解胆总管结石并胆道感染患者胆汁中致病菌的分布以及耐药性的情况,为临床中胆总管结石并胆道感染患者的诊治提供参考。方法:选取2012年1月至2012年12月期间被我院收治的胆总管结石并胆道感染患者内镜逆行胰胆管造影术(ERCP)抽取胆汁标本150例,对其进行细菌培养和药敏试验,观察和分析细菌分布情况和耐药性情况。结果:1细菌培养阳性的例数为123例(阳性检出率82.0%),其中,革兰氏阴性菌39例(31.71%),主要为大肠埃希菌23例(18.70%);革兰氏阳性菌64例(52.03%),主要是粪肠球菌22例(17.89%)和甲型溶血性链球菌10例(8.13%);真菌(白假丝酵母菌)20例(16.26%)。2患者胆汁中的细菌主要敏感的药物有美罗培南、亚胺培南、万古霉素、庆大霉素、头孢吡肟和阿米卡星等。结论:胆总管结石并胆道感染患者胆汁中病原菌分布出现了新的变化,临床中应根据患者胆汁药敏试验结果选择有效的治疗方法和抗菌药物。Objective： To study the situation of biliary infection distribution and drug resistance of pathogenic bacteria in patients bile with common bile duct stones and biliary tract infection and to provide a reference for the clinical diagnosis and treatment in patients with common bile duct stones combined biliary tract infection. Methods： 150 cases of bile specimens extracted via endoscopic retrograde pancreatic angiography （ERCP） from patients with common bile duct stones combined biliary tract infection during the period of January 2012 to December 2012 in our hospital were selected, the bacterial distribution and drug resistance were observed and analyzed. Results： ①There were 123 germiculture positive cases （positive detection rate 82.0%）. Among them, gram negative bacteria were detected in 39 cases （31.71%）, 23 cases of which were e. coli （18.70%）; Gram positive bacteria were detected in 64 cases （52.03%）, mainly consisted of 22 cases of dung enterococcus （17.89%） and 10 cases of alpha hemolytic streptococcus （8.13%）; White fungus （candida） were dectected in 20 cases （16.26%）. ②The main sensitive drugs to biliary bacteria were Meropenem, Imipenem, Vancomycin, Gentamicin, Cefepime and Amy card magnitude. Conclusion： Bacteria distribution in patients with common bile duct stones combined biliary tract infection present changes. Effective treatment and antibacterial drugs can be utilized in clinic according to patients biliary drug susceptibility test results.

关 键 词：胆管结石并胆道感染 胆汁 ERCP 病原菌 药敏试验 

分 类 号：R657.4[医药卫生—外科学]