新昌地区胆汁病原菌谱和耐药性分析  

Analysis of pathogenic bacteria spectrum and drug resistance of bile in Xinchang area

作　　者：张筱蓉[1] 朱美英[1] 潘亚元[1] 王江妹 ZHANG Xiao-rong;ZHU Mei-ying;PAN Ya-yuan;WANG Jiang-mei(Clinical Laboratory,Xinchang County People's Hospital,Zhejiang 312500,China)

机构地区：[1]新昌县人民医院检验科,浙江312500

出　　处：《中国卫生检验杂志》2023年第8期932-935,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨新昌地区胆道感染患者的病原菌谱及耐药特征,为临床治疗和防控提供实验室依据。方法对2019年1月—2021年12月临床送检的胆汁培养阳性标本进行回顾性分析。对患者的临床资料和实验室数据进行搜集。结果619株菌株源于586例患者,33例患者为混合感染。革兰阴性菌350株,占56.5%;革兰阳性菌203株,占32.8%;真菌66株,占10.7%。肠球菌对利奈唑胺、替加环素100%敏感,对替考拉宁均保持较高的敏感率。大肠埃希菌、肺炎克雷伯杆菌、阴沟肠杆菌对阿米卡星、头孢哌酮/舒巴坦、厄他培南、亚胺培南、替加环素保持20%以下的耐药率。嗜麦芽窄食单胞菌对多药呈天然耐药现象。结论胆道感染的病原菌以肠球菌和大肠埃希菌为主,胆道感染不同病原菌耐药性差异较大,嗜麦芽窄食单胞菌的治疗应予以足够的重视。临床在早期经验用药的同时应尽快进行病原学检测,根据药敏结果及时调整治疗方案,提高临床治愈率。Objective This paper aims to understand the pathogenic bacteria spectrum and drug resistance in patients with biliary tract infection so as to provide guidance for reasonable use of antibiotic.Methods The clinical bile culture positive specimens from January 2019 to December 2021 were analyzed retrospectively.The clinical data and laboratory data of patients were collected.Results A total of 619 strains originated from 586 patients,33 patients were mixed infection.350 strains of gram-negative bacteria accounted for 56.5%;203 strains of gram-positive bacteria accounted for 32.8%;66 strains of Fungi accounted for 10.7%.Enterococcus was 100%sensitive to linezolid and tigecycline,and kept a high sensitivity rate to teicoplanin.The resistance rates of Escherichia coli,Klebsiella pneumoniae and Enterobacter cloacae to amikacin,cefoperazone/sulbactam,ertapenem,imipenem and tigecycline remained below 20%.Stenotrophomonas maltophilia is naturally resistant to multiple drugs.Conclusion Enterococcus and Escherichia coli are the main pathogens of biliary tract infection,and the drug resistance of different pathogens of biliary tract infection is quite different.Attention should be paid to the treatment of Stenotrophomonas maltophilia.In the early clinical experience,pathogen detection should be carried out as soon as possible,and the treatment plan should be adjusted in time according to the drug sensitivity results so as to improve the clinical cure rate.

关 键 词：新昌地区 胆汁培养 病原菌 嗜麦芽窄食单胞菌 耐药特征 

分 类 号：R446.5[医药卫生—诊断学]