摘要
目的研究胆道感染病原菌分布及其耐药性,为临床医师合理用药提供实验室依据。方法对医院2013年1月-2014年2月经内镜逆行性胰胆管造影术(ERCP)术中所取胆汁标本219份进行培养,使用VITEK-2Compact仪器进行细菌鉴定和药敏试验;采用WHONET5.4软件统计药物敏感率。结果 219份胆汁标本共培养出病原菌147株,其中革兰阴性菌109株占74.1%,以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主,革兰阳性菌30株占20.4%,以屎肠球菌和粪肠球菌为主,真菌8株占5.5%;大肠埃希菌对碳青霉烯类高度敏感,无耐药发生,对哌拉西林、头孢曲松、头孢唑林的耐药率最高,均为98.3%;肺炎克雷伯菌对碳青霉烯类、哌拉西林/他唑巴坦、头孢替坦高度敏感,无耐药发生,对哌拉西林、氨苄西林的耐药率最高,均为100.0%;铜绿假单胞菌对阿米卡星高度敏感,无耐药发生,对磺胺甲噁唑/甲氧苄啶、头孢曲松、头孢唑林、氨苄西林/舒巴坦、呋喃妥因、氨苄西林、头孢替坦的耐药率最高,均为100.0%;屎肠球菌和粪肠球菌均对替加环素高度敏感,无耐药发生,对克林霉素、红霉素的耐药率最高,均为100.0%。结论胆道感染不同病原菌耐药性差异较大,临床医师在经验用药的同时应尽快送检进行病原学检测,根据药敏结果合理使用抗菌药物。
OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing biliary tract infections so as to provide laboratory basis for reasonable clinical use of antibiotics.METHODS A total of 219 bile specimens were collected from the patients who underwent the endoscopic retrograde cholangiopancreatography（ERCP）in the hospital from Jan 2013 to Feb 2014,then they were cultured,the isolated pathogens were identified by using VITEK-2Compact system,the drug susceptibility testing was performed,and the drug susceptibility rates were statistically analyzed with the use of WHONET5.4software.RESULTS Totally 147 strains of pathogens were cultured from the 219 bile specimens,including 109（74.1%）strains of gram-negative bacteria,30（20.4%）strains of gram-positive bacteria,and 8（5.5%）strains of fungi.Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa were dominant among the gram-negative bacteria;Enterococcus faecium and Enterococcus faecalis were the predominant species of the gram-positive bacteria.E.coli strains were highly susceptible to carbapenems,with the drug resistance rate of 0,and the drug resistance rates to piperacillin,ceftriaxone,and cefazolin were 98.3%.K.pneumoniae strains were highly susceptible to carbapenems,piperacillintazobactam,and cefotetan,with the drug resistance rates of 0,and the drug resistance rates to piperacillin and ampicillin were 100.0%.P.aeruginosastrains were highly susceptible to amikacin,with the drug resistance rate of 0,and the drug resistance rates to sulfamethoxazole-trimethoprim,ceftriaxone,cefazolin,ampicillin-sulbactam,nitrofurantoin,ampicillin,and cefotetan were 100.00%.E.faeciumand E.faecalis strains were highly susceptible to tigecycline,with the drug resistance rate of 0,and the drug resistance rates to clindamycin and erythromycin were 100.0%.CONCLUSIONThe pathogens causing the biliary tract infections vary significantly in the drug resistance.It is necessary for the clinicians to conduct the etiological examination of the submi
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第17期3899-3900,3905,共3页
Chinese Journal of Nosocomiology
基金
陕西省科技攻关基金资助项目(2012K06-31)
关键词
胆道感染
病原菌
耐药性
Biliary tract infection
Pathogen
Drug resistance
