老年人胆道感染85例临床分析  

Clinical analysis on 85 elderly patients with biliary tract infections

作　　者：高勤革[1] 花天放[1] 韩松[1] 

机构地区：[1]上海市第一人民医院分院外科,200081

出　　处：《中国抗感染化疗杂志》2004年第3期133-135,共3页Chinese Journal of Infection and Chemotherapy

摘　　要：目的 :探讨老年人胆道感染的临床病原学特点及细菌耐药状况 ,指导临床合理用药。方法 :回顾性分析 1999年 1月— 2 0 0 3年 5月 85例老年胆道感染胆汁标本中病原学的检出。结果 :85份标本中有 5 8份胆汁培养有细菌生长 ,阳性率为 6 8.2 % (5 8/ 85 ) ,其中混合感染标本占 17.2 % (10 / 5 8) ,分离细菌 70株 ,革兰阴性杆菌 5 7株占 81.4 % ,主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌。革兰阳性球菌 13株占 18.6 % ,主要为肠球菌属和金黄色葡萄球菌。分离的革兰阴性杆菌对亚胺培南、头孢吡肟、头孢他啶等敏感性较高 ,可作为老年重症胆道感染的首选用药 ,而对庆大霉素、环丙沙星有较高的耐药性 ,不宜作为老年胆道感染患者的经验性治疗用药。结论 :对老年胆道感染病原学的监测 ,有利于选择有效的抗菌药物 ,减少治疗的盲目性。Objective: To investigate the etiological pathogens of biliary tract infections in elderly and their susceptibility to antimicrobial agents for the guidance of rational use of antibiotics. Methods:Pathogens isolated from bile of 85 elderly patients with biliary tract infections from January 1999 to May 2003 were analyzed retrospectively. Results:A total of 70 strains of bacteria were isolated from 58 of the 85 elderly patients, with positive rate of 68.2%. Two or more strains were isolated from ten patients(17.2%). Of the 70 strains, 81.4% were gram-negative bacilli including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa etc. Gram-positive cocci accounted for 18.6%, most of them being Enterococcus spp. and Staphylococcus aureus. Gram-negative bacilli were highly susceptible to imipenem, cefepime and ceftazidime, which suggest that these agents could be used for the treatment of severe biliary infections in elderly patients. The resistance rates of Gram-negative bacilli to penicillin, gentamicin and ciprofloxacin were high, this result suggest that these antibiotics are not suitable for the empirical treatment of biliary tract infections in elderly patients. Conclusions:It is important to survey bacterial resistance in the etiological pathogens of biliary infections in elderly patients.

关 键 词：胆道感染 老年患者 抗菌药 

分 类 号：R575.6[医药卫生—消化系统]