急性胆囊炎胆汁细菌培养临床特征分析  

Clinical characteristics of bile bacterial culture in acute cholecystitis

作　　者：张宁生 郝睿文 徐多峰 周廷奉 马瑞军 ZHANG Ningsheng;HAO Ruiwen;XU Duofeng;ZHOU Tingfeng;MA Ruijun(Yanchi County People′s Hospital of Ningxia,Yanchi 751500,China;Tongxin County People′s Hospital of Ningxia,Tongxin 751300,China)

机构地区：[1]宁夏盐池县人民医院,宁夏吴忠751500 [2]宁夏同心县人民医院,宁夏吴忠751300

出　　处：《宁夏医学杂志》2024年第11期979-982,共4页Ningxia Medical Journal

摘　　要：目的 了解急性胆囊炎患者胆汁中的病原菌分布特点和相关危险因素。方法 回顾性分析124例急性胆囊炎患者的胆汁标本,分析患者的临床资料及细菌培养结果。结果 共有124份胆汁标本被送检,其中65例患者的胆汁细菌培养呈阳性,阳性率为52.41%;共分离出菌株79株。大多数为肠道菌群,其中肠球菌31株、大肠埃希菌21株、肠杆菌11株、肺炎链球菌9株、肺炎克雷伯菌2株、鲍曼不动杆菌2株、链球菌2株、白念珠菌1株。主要菌群的药敏分析结果显示,大肠埃希菌对哌拉西林、头孢呋辛和氨苄西林/舒巴坦耐药率较高;肠球菌对红霉素、环丙沙星耐药率较高;肠杆菌对抗生素普遍敏感。多因素分析发现,年龄≥60岁、既往胆道手术、持续发热、胆红素是胆汁培养阳性的独立危险因素。结论 急性胆囊炎胆汁中的病原菌多为肠球菌群。个体化使用抗生素并关注高龄及既往胆道手术等因素,有助于提高急性胆囊炎的临床管理效果。Objective To analyze the distribution characteristics and related risk factors of pathogens bacteria in the bile of patients with acute cholecystitis.Methods Retrospective analysis was conducted to the bile specimens of 124 patients with acute cholecystitis,and the clinical data and bacterial culture results of patients were recorded and analyzed.Results A total of 124 bile specimens were sent for examination,which 65 patients showed positive bacterial cultures,a positivity rate of 52.41%,79 strains were isolated.The majority were intestinal flora,including 31 strains of Enterococcus,21 strains of Escherichia coli,11 strains of Enterobacter,9 strains of Streptococcus pneumoniae,two strains of Klebsiella pneumoniae,two strains of Acinetobacter baumannii,two strains of Streptococcus,and one strain of Candida albicans.Drug sensitivity analysis of the main bacterial groups showed that Escherichia coli had a higher resistance rate to piperacillin,cefoxitin,and ampicillin/sulbactam;Enterococcus were more sensitive to tigecycline and vancomycin but had a higher resistance rate to erythromycin and ciprofloxacin;Enterobacter was generally sensitive to antibiotics.Multifactorial analysis identified that age≥60 years,previous biliary surgery,persistent fever,and bilirubin were independent risk factors for positive bile cultures.Conclusion Pathogenic bacteria in the bile of acute cholecystitis are mostly enterococcus flora.Individualized use of antibiotics and attention to factors such as advanced age and previous biliary surgery can help improve the clinical management of acute cholecystitis.

关 键 词：胆汁 细菌培养 病原菌 

分 类 号：R575.61[医药卫生—消化系统]