胆道结石合并急性胆管炎患者胆汁病原菌分布及耐药性分析  

Distribution of pathogens causing cholangitis with cholangiolithiasis and analysis of antimicrobial resistance

作　　者：严富国[1] 杨红江[1] 王方平[1] 

机构地区：[1]新昌县人民医院,浙江新昌312500

出　　处：《中国卫生检验杂志》2015年第12期2042-2044,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析胆道结石合并急性胆管炎患者胆汁病原菌分布及耐药情况,为合理选用抗菌药物提供科学依据。方法分析本院2011年3月-2014年6月共176例胆道结石合并急性胆管炎患者的临床资料。结果共送检232份胆汁标本,185份检出病原菌,阳性率为79.7%,共检出菌株204株;革兰阴性杆菌144株(70.6%),革兰阳性球菌52株(25.5%),真菌3株(1.5%);大肠埃希菌检出最多为62株(30.4%)。大肠埃希菌、肺炎克雷伯菌对哌拉西林/他唑巴坦、美罗培南及亚胺培南的耐药率较低;铜绿假单胞菌对大多数常用抗菌药物均产生了较高的耐药性;粪肠球菌和屎肠球菌对左氧氟沙星的耐药率均较高,对万古霉素、替考拉宁无耐药;真菌对常用抗真菌药物敏感性较好。结论本院引起胆道结石合并急性胆管炎的病原菌以革兰阴性杆菌为主,应根据药敏试验结果合理选用抗菌药物。Objective To study the distribution and antimicrobial resistance of pathogens causing cholangitis with cholangiolithiasis,so as to provide scientific evidence for the reasonable use of antibiotics. Methods The clinical data collected from a total of 176 patients with cholangitis and cholangiolithiasis was analyed retrospectively in the hospital from March 2011 to June 2014.Results A total of 232 specimens were tested,the pathogens was detected in 185 of them with the positive rate of 79. 7%,and a total of 204 strains were detected; 144 strains of gram- negative bacilli,52 strains of gram- positive cocci and 3 strains of fungi were detected,accounting for 70. 6%,25. 5%,and 1. 5% respectively; the most detection ones were 62 strains of Escherichia coli,accounting for 30. 4%. Escherichia coli and Klebsiella pneumoniae showed lower drug resistance rates to piperacillin-tazobactam,meropenem and imipenem; the drug resistance rates of Pseudomonas aeruginosa were higher to the most of commonly used antibacterial drugs; the drug resistance rates of Enterococcus faecalis and Enterococcus faecium were higher to ciprofloxacin and levofloxacin,were both zero to vancomycin and teicoplanin; the fungi were susceptible to the commonly used antifungal drugs; the antifungal susceptibility of common antifungal agents was better. Conclusion The pathogens causing cholangitis with cholangiolithiasis were mainly gram- negative bacilli,medical staff should choose reasonably antibacterial drugs according to antimicrobial susceptibility test results.

关 键 词：胆道结石 胆管炎 病原菌 分布 耐药性 

分 类 号：R575.6[医药卫生—消化系统]