胆道感染患者胆汁和血培养主要病原菌一致性研究  

Preliminary Study on Pathogenic Bacteria in Bile and Blood Culture of Patients with Biliary Tract Infection

作　　者：郑礼杰[1] 陈建国[1] 张金[2] 李节[1] ZHENG Li-jie;CHEN Jian-guo;ZHANG Jin;LI Jie(Department of Clinical Laboratory,People’s Hospital Affiliated to JiangsuUniversity,Jiangsu Zhenjiang 212002,China;Department of Respiratory Medicine,People’s Hospital Affiliated to JiangsuUniversity,Jiangsu Zhenjiang 212002,China)

机构地区：[1]江苏大学附属人民医院检验科,江苏镇江212002 [2]江苏大学附属人民医院呼吸内科,江苏镇江212002

出　　处：《现代检验医学杂志》2020年第2期124-127,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨胆道感染患者胆汁培养和血培养主要病原菌的一致性。方法回顾性分析2016年1月~2019年6月江苏大学附属人民医院胆汁和血培养同时阳性的114例胆道感染患者的资料,比较胆汁和血液两种类型标本中病原菌的分布,采用Kappa检验分析其一致性。结果 116份胆汁标本共检出148株菌,革兰阴性菌占71.62%,革兰阳性菌占27.03%,真菌占1.35%。126份血液标本共检出129株菌,革兰阴性菌占82.95%,革兰阳性菌占16.28%,真菌占0.78%。有45例患者(39.47%)的胆汁和血标本分别只检出一种菌,且相同;28例(24.56%)的胆汁和血标本检出病原菌至少一种相同;41例(35.96%)的胆汁和血标本检出病原菌完全不同。胆汁和血培养检出大肠埃希菌的总符合率为61.40%。胆汁和血标本检出菌至少一种相同的患者中,大肠埃希菌检出率在两种标本类型中表现出较高的一致性(Kappa值=0.784),符合率为89.3%。结论胆道感染患者的胆汁和血培养病原菌以革兰阴性杆菌为主,其中大肠埃希菌占比最高。两种标本类型在大肠埃希菌检出率上具有较高一致性。Objective To explore the concordance of main pathogenic bacteria in bile and blood of patients with biliary tract infection. Methods The data of 114 patients with bile and blood culture positive in the same period in the Affiliated People’s Hospital of Jiangsu University from January 2016 to June 2019 were enrolled and the distribution of pathogenic bacteria in bile and blood samples was compared. The Kappa test was used to determine the concordance. Results A total of 148 strains of bacteria were detected in 116 bile samples. Gram-negative bacteria accounted for 71.62%, Gram positive bacteria accounted for 27.03% and fungi accounted for 1.35%. A total of 129 strains of bacteria were detected in 126 blood samples, including 82.95% of Gram-negative bacteria, 16.28% of Gram-positive bacteria and 0.78% of fungi. There were 45 cases(39.47%) of bile and blood samples detected only one same kind of bacteria. 28 cases(24.56%) of bile and blood samples detected at least one same kind of pathogens, 41 cases(35.96%) of bile and blood samples detected pathogens were completely different. The total coincidence rate of Escherichia coli detected by bile and blood culture was 61.40%. In patients with at least one same kind of bacteria detected in bile and blood samples, the detection rate of Escherichia coli showed a high consistency between the two sample types(Kappa value = 0.784), with a coincidence rate of 89.3%. Conclusion Gram-negative bacteria was the main pathogen in bile and blood culture of patients with biliary tract infection, and Escherichia coli accounted for the highest proportion. There was a high consistency in the detection rate of Escherichia coli between the two sample types.

关 键 词：胆道感染 病原菌 一致性 

分 类 号：R575.7[医药卫生—消化系统] R446.5[医药卫生—内科学]