2011~2013年某院胆道感染病原菌与细菌耐药性分析  

Analysis of pathogens resistant bacterial infection of the biliary 2011-2013

作　　者：吴晓春[1] 侯章梅 成燕[2] 杨薇[2] 颜令[3] 

机构地区：[1]重庆市第三人民医院肝胆外科,400014 [2]重庆市第三人民医院医院感染管理科,400014 [3]重庆市第三人民医院医学检验科,400014

出　　处：《重庆医学》2015年第30期4207-4209,4212,共4页Chongqing medicine

摘　　要：目的了解胆总管结石伴胆道感染患者胆汁中主要病原菌分布及药物敏感性特点,为合理使用抗菌药物提供依据。方法对该院2011年1月至2013年12月296例胆汁标本进行回顾性调查,分析细菌培养结果及耐药情况。结果 296例胆汁标本中有199例检出致病菌,阳性率占67.23%,其中21例检出两种细菌,共检出220株病原菌,其中革兰阴性菌158株,占71.82%;革兰阳性菌46株,占20.91%;真菌16株,占7.27%;革兰阴性菌对阿米卡星耐药率均较低,其次对他唑巴坦、氨曲南、三四代头孢菌素及喹诺酮类的耐药率相对较低。革兰阴性菌中耐药性最高的为铜绿假单胞菌和大肠埃希菌,对大部分抗菌药物耐药率均大于50.00%。革兰阳性球菌对替加环素的耐药率均为0,对万古霉素、利奈唑胺的耐药率小于30.00%,而对红霉素、克林霉素、氯洁霉素高度耐药,耐药率70.00%~100.00%。结论 296例胆总管结石伴胆道感染患者胆汁,主要病原菌是大肠埃希菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌及屎肠球菌,对青霉素类耐药性较高。Objective To understand the main pathogenic bacteria distribution and drug susceptibility in the common bile duct calculi with infection ,so as to provide the basis for rational use of antimicrobial agents .Methods Data′s of 296 cases of bile specimens treated from January 2011 to December 2013 were retrospectively surveyed and drug resistance of bacteria culture results were analyzed .Results Among all the 296 cases ,there were 199 cases of pathogenic bacteria in bile specimens ,the positive rate was 67 .23% ;among them ,there were 21 cases of two kinds of bacteria ,a total of 220 strains of pathogenic bacteria were detected ,and among them there were 158 strains of gram negative bacteria ,accounting for 71 .82% ;there were 46 strains of gram positive bacte‐ria ,accounting for 20 .91% ;there were 16 strains of fungi ,accounting for 7 .27% ;the lowest resistance of gram negative bacilli lies in amikacin ,followed by tazobactam ,aztreonam ,three to four generations of cephalosporins and quinolone .Gram negative bacilli has the highest drug resistance to pseudomonas aeruginosa and e .coli ,and it has a drug resistant rate higher than 50 .00% to most anti‐microbial drugs .Gram positive cocci has 0 drug resistance rate to add ring element ,has a drug resistance rate lower than 30 .00% to vancomycin and rina thiazole amine ,and has highest drug resistance rate （70 .00% -100 .00% ） to erythromycin ,clindamycin and chlorine lincomycin .Conclusion Among all the 296 cases of common bile duct calculi bile with biliary tract infection ,the main path‐ogenic bacteria were e .coli ,klebsiella pneumoniae ,eosinophilic malt narrow and excrement enterococcus bacterium ;and the drug re‐sistance to penicillin is highest .

关 键 词：胆总管结石 胆道感染 病原菌 监测 

分 类 号：R446.5[医药卫生—诊断学]