某院梗阻性黄疸合并感染患者胆汁标本中病原菌的分布及其耐药性分析  

Analysis of Distribution and Drug Resistance of Pathogens in Bile Specimens from Patients with Obstructive Jaundice Complicated by Infection in a Hospital

作　　者：赵阳 ZHAO Yang(Department of Laboratory,the Fifth People's Hospital of Anyang,Anyang,Henan 455000)

机构地区：[1]安阳市第五人民医院检验科,河南安阳455000

出　　处：《抗感染药学》2022年第4期500-503,共4页Anti-infection Pharmacy

摘　　要：目的:探究梗阻性黄疸(obstructive jaundice,OJ)合并感染患者胆汁标本中病原菌的分布与耐药特点。方法:选取2018年1月—2021年4月安阳市第五人民医院收治的219例OJ合并感染患者的病历资料,统计患者胆汁标本的微生物培养及其药敏试验结果,分析病原菌的分布和主要病原菌的耐药特点。结果:219例OJ合并感染患者胆汁标本中共分离出210株病原菌,其中革兰阴性菌163株(占77.62%,以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主)、革兰阳性菌39株(占18.57%,以粪肠球菌、屎肠球菌为主)和真菌8株(占3.81%);药敏结果显示,大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦钠、阿米卡星、哌拉西林-他唑巴坦钠的耐药率均较低(<20.00%),粪肠球菌和屎肠球菌对利奈唑胺、替考拉宁、万古霉素和氯霉素的耐药率均较低(<20.00%)。结论:OJ合并感染患者的病原菌主要为革兰阴性菌,革兰阳性菌比例较低,临床应根据微生物培养和药敏试验结果合理选用抗菌药物,以确保抗感染治疗的效果。Objective: To investigate the distribution and drug resistance characteristics of pathogenic bacteria in bile specimens from patients with obstructive jaundice(OJ) complicated by infection. Methods: The medical records of 219 patients with OJ complicated by infection who were admitted to the Fifth People’s Hospital of Anyang from January 2018 to April 2021 were selected, and the results of microbiological culture and drug susceptibility tests of bile specimens from the patients were summarized to analyze the distribution of pathogenic bacteria and the drug resistance characteristics of major pathogenic bacteria. Results: A total of 210 pathogenic bacteria were isolated from the bile specimens from 219 patients with OJ complicated by infection, including 163 Gram-negative bacteria(accounting for77.62%, mainly Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa), 39 Gram-positive bacteria(accounting for 18.57%, mainly Enterococcus faecalis and Enterococcus faecium) and 8 fungi(accounting for 3.81%).The drug susceptibility results showed that Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa had low resistance rates(<20.00%) to imipenem, meropenem, cefoperazone-sulbactam sodium, amikacin and piperacillintazobactam sodium, and Enterococcus faecalis and Enterococcus faecium had low resistance rates(<20.00%) to linezolid,teicoplanin, vancomycin and chloramphenicol. Conclusion: The pathogenic bacteria in patients with OJ complicated by infection are mainly Gram-negative bacteria, and Gram-positive bacteria are of a low proportion, so clinical antibacterial drugs should be selected rationally according to the results of microbiological culture and drug susceptibility tests to ensure the effect of anti-infection treatment.

关 键 词：梗阻性黄疸 感染 胆汁标本 病原菌分布 耐药性 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]