2010-2014年胆汁培养病原菌分布与耐药性研究  

Distribution and drug resistance of pathogens from bile culture in 2010-2014

作　　者：卢晋英[1] 张健东[1] 张富玉[2] 王宇凡[1] 张磊[1] 刘树业[1] 

机构地区：[1]天津市第三中心医院检验科,天津300170 [2]天津市第三中心医院感染科,天津300170

出　　处：《中华医院感染学杂志》2015年第21期4841-4843,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生行业重点攻关基金资助项目(2013KY02)

摘　　要：目的了解临床胆汁培养的主要病原菌分布及耐药性变迁,为胆道感染患者的治疗与预防提供科学依据。方法回顾性调查2010年1月-2014年12月1 116例住院患者胆汁培养分离的病原菌类型及药敏结果;采用法国生物梅里埃公司VITEK-2Compact全自动微生物分析系统进行细菌鉴定,采用WHONET5.6软件进行统计分析。结果 1 116例住院患者胆汁培养标本非重复分离的病原菌725株,其中以革兰阴性菌最多544株占75.0%,前5位依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌和阴沟肠杆菌,分别占39.9%、11.0%、9.2%、5.5%、4.6%;分离革兰阳性菌172株占23.7%,主要以粪肠球菌和屎肠球菌为主;真菌9株占1.3%;革兰阴性菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、阿米卡星、哌拉西林/他唑巴坦的耐药率较低0~30.0%,可作为胆道感染的预防和经验用药。结论严格执行《抗菌药物临床应用管理办法》,了解胆道感染的病原菌种类和耐药特点,根据药敏结果合理选择抗菌药物,是控制胆道感染和提高治愈率的有效措施。OBJECTIVE To investigate the distribution and drug resistance of major species of pathogens cultured from clinical bile specimens so as to provide scientific basis for prevention and treatment of biliary tract infections.METHODS A retrospective survey was conducted for the distribution and drug susceptibility testing results of the pathogens cultured from the bile specimens that were obtained from 1 116 patients who were hospitalized from Jan2010 to Dec 2014.The isolated pathogens were identified by using VITEK-2Compact automatic microorganism analysis system of bioMerieux,France,and the statistical analysis was performed with the use of WHONET5.6software.RESULTS A total of 725 strains of non-repetitive pathogens were isolated from the bile specimens of the1 116 hospitalized patients,including 544（75.0%）strains of gram-negative bacteria,172（23.7%）strains of gram-positive bacteria,and 9（1.3%）strains of fungi.The Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,and Enterobacter cloacae ranked the top 5species of gram-negative bacteria,accounting for 39.9%,11.0%,9.2%,5.5%,and 4.6%,respectively;the Enterococcus faecalis and Enterococcus faecium were the predominant species of the gram-positive bacteria.The drug resistance rates of the gram-negative bacteria to imipenem,meropenem,cefoperazone-sulbactam,amikacin,and piperacillin-tazobactam ranged between 0and 30.0%,and the above antibiotics could be used for prevention of biliary tract infections and empirical medication.CONCLUSION It is an effective way to strictly implement＇Measures for the management of clinical application of antibacterial drugs＇,understand the distribution and drug resistance of the pathogens causing the biliary tract infections,and reasonably use antibiotics based on the drug susceptibility testing results so as to control the biliary tract infections and raise the cure rate.

关 键 词：胆汁培养 病原菌 耐药性 胆道感染. 

分 类 号：R378[医药卫生—病原生物学]