摘要
目的分析胆结石合并胆道感染胆汁中病原菌的分布及药敏性,为临床合理用药提供参考。方法选取2009年3月-2014年3月收治的82例胆结石合并胆道感染患者,对患者利用内镜逆行胰胆管造影术进行检查,抽取胆汁样本进行病原菌的分布以及药敏分析,采用EpiData 3.1软件进行统计分析。结果 82例胆汁标本培养阳性的为78例,检出率为95.1%,共检出病原菌85株,其中革兰阴性菌59株占69.4%,革兰阳性菌18株占21.2%,真菌8株占9.4%;革兰阴性菌对亚胺培南的耐药率最低,其次为妥布霉素、哌拉西林/他唑巴坦、头孢吡肟及阿米卡星等,耐药率均<30.0%;革兰阳性菌对万古霉素的耐药率最低,其次为庆大霉素、链霉素、环丙沙星、利福平等,耐药率均<15.0%。结论胆结石合并胆道感染患者胆汁中病原菌的分布发生了新的变化,大肠埃希菌、肠球菌属及肺炎克雷伯菌等是其主要病原菌,在临床上,应根据患者胆汁药敏试验结果对抗菌药物进行合理选择。
OBJECTIVE To investigate the distribution and drug susceptibility of the pathogens isolated from the bile specimens of the gallstones patients complicated with biliary tract infections so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 82 gallstones patients complicated with biliary tract infections who were treated from Mar 2009 to Mar 2014 were enrolled in the study,all the participants received the endoscopic retrograde cholangiopancreatography,then the bile specimens were sampled to observe the distribution and drug susceptibility of the pathogens,and the statistical analysis was performed with the use of EpiData3.1.RESULTS Of 82 bile specimens,78 were cultured positive,with the detection rate of 95.1%.Totally 85 strains of pathogens have been isolated,including 59(69.4%)strains of gram-negative bacteria,18(21.2%)strains of gram-positive bacteria,and 8(9.4%)strains of fungi.The drug resistance rate of the gram-negative bacteria to imipenem was the lowest,and the drug resistance rates to tobramycin,piperacillin-tazobactam,cefepime,and amikacin were less than 30.0%.The drug resistance rate of the gram-positive bacteria to vancomycin was the lowest,and the drug resistance rates to gentamicin,streptomycin,ciprofloxacin,and rifampicin were less than15.0%.CONCLUSIONThere is a new change in the distribution of the pathogens isolated from the bile specimens that are obtained from the gallstones patients complicated with biliary tract infections.Escherichia coli,Enterococcus spp,and Klebsiella pneumoniae are the predominant pathogens.It is necessary for the hospital to reasonably use antibiotics based on the results of drug susceptibility testing for the pathogens isolated from the bile specimens.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第8期1747-1749,共3页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技基金资助项目(2011YCG147)
关键词
胆结石
胆道感染
胆汁
病原菌
药敏试验
Gallstone
Biliary tract infection
Bile
Pathogen
Drug susceptibility testing