胆石症合并胆道感染患者胆汁细菌培养病原菌分布及耐药性  

Distribution and Drug Resistance of of Pathogenic Bacteria in Bile Bacterial Culture of Patients with Cholelithiasis Complicated with Biliary Tract Infection

作　　者：林建漳 袁祥洪 LIN Jianzhang;YUAN Xianghong(Longyan People's Hospital,Longyan 364000,China)

机构地区：[1]龙岩人民医院,福建龙岩364000

出　　处：《中外医学研究》2024年第26期81-85,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析胆石症合并胆道感染患者胆汁细菌培养病原菌分布及耐药性,对临床抗生素的合理使用提供依据。方法:选取2020年1月—2023年6月龙岩人民医院入院诊断为胆石症合并胆道感染的150例患者,收集所有患者胆汁并进行细菌培养和药敏试验,统计试验结果,分析病原菌主要分布情况及对抗菌药物的耐药性。结果:150例胆石症合并胆道感染患者,共培养出病原菌248株,革兰阴性菌175株(70.56%),以大肠杆菌、肺炎克雷伯杆菌、阴沟弗肠杆菌为主;革兰阳性菌52株(20.97%),以粪肠球菌、屎肠球菌为主;真菌21株(8.47%)。耐药性结果显示,大肠杆菌对氨苄西林、头孢唑林的耐药性较高(耐药率>60%),对阿米卡星不耐药(敏感率达100.0%);肺炎克雷伯菌对氨苄西林耐药性最高,为100.0%,对阿米卡星不耐药;阴沟弗肠杆菌对氨苄西林/舒巴坦、氨苄西林、头孢呋辛、头孢唑啉、头孢西丁耐药率为100.0%。对头孢吡肟、米诺环素、亚胺培南、美洛培南、阿米卡星不耐药。结论:胆石症合并胆道感染患者的致病菌多为革兰阴性菌,其次为革兰阳性菌,且不同致病菌对抗菌药物耐药率不同,因此,临床应依据药敏试验结果合理选用抗菌药物,在确保其临床疗效的同时减轻患者负担,减少耐药菌株。Objective:To explore the distribution and drug resistance of of pathogenic bacteria in bile bacterial culture of patients with cholelithiasis complicated with biliary tract infection,providing a basis for the rational use of clinical antibiotics.Method:A total of 150 patients with cholelithiasis complicated with biliary tract infection who admitted to Longyan People's Hospital from January 2020 to June 2023 were selected,bile was collected from all patients for bacterial culture and drug sensitivity test,the results of the test were statistically analyzed,and the main distribution of pathogenic bacteria and their resistance to antibiotics were analyzed.Result:Among 150 patients with cholelithiasis complicated with biliary tract infection,248 strains of pathogenic bacteria were cultured,including 175 strains(70.56%)of Gram-negative bacteria,mainly Escherichia coli,Klebsiella pneumoniae and Enterobacter cloacae;52 strains(20.97%)of Gram-positive bacteria,mainly Enterococcus faecalis and Enterococcus faecium;21 strains(8.47%)of fungi.The results of drug resistance showed that Escherichia coli was highly resistant to Ampicillin and Cefazolin(resistance rate>60%),but not resistant to Amikacin(sensitivity rate was 100.0%).Klebsiella pneumoniae had the highest resistance to Ampicillin(100.0%)and was not resistant to Amikacin.The resistance rate of Enterobacter cloacae to Ampicillin/Sulbactam,Ampicillin,Cefuroxime,Cefazolin and Cefoxitin were 100.0%.It was not resistant to Cefepime,Minocycline,Imipenem,Meropenem and Amikacin.Conclusion:The pathogenic bacteria of patients with cholelithiasis complicated with biliary tract infection are mostly Gram-negative bacteria,followed by Gram-positive bacteria,and different pathogenic bacteria have different resistance rates to antibiotics.Therefore,antibiotics should be rationally selected according to the results of drug sensitivity test,so as to reduce the burden of patients and drug-resistant strains while ensuring their clinical efficacy.

关 键 词：胆石症 胆道感染 细菌 敏感性 耐药性 

分 类 号：R575.62[医药卫生—消化系统] R446.5[医药卫生—内科学]