摘要
目的对胆总管结石伴胆道感染患者进行胆汁培养,对其病原菌分布及耐药性进行统计分析,为临床用药提供指导。方法选取医院2012年1月-2013年2月120例胆总管结石患者为研究对象,所有患者行内镜逆行胰胆管造影术(ERCP),术中抽取胆汁标本,进行细菌培养及药敏分析。结果 120例胆总管结石患者中96例检出病原菌,检出率为80.0%;共分离出病原菌107株,其中革兰阴性菌共检出75株占70.1%,革兰阳性菌30株占28.0%,真菌2株占1.9%;大肠埃希菌对亚胺培南、美罗培南及环丙沙星较敏感,耐药率<20.0%,肺炎克雷伯菌和铜绿假单胞菌对亚胺培南、美罗培南高度敏感,耐药率均为0;粪肠球菌对万古霉素、磷霉素及氯霉素较为敏感,耐药率<10.0%;真菌对酮康唑、伊曲康唑、制霉菌素及两性霉素较敏感。结论引起胆总管结石患者胆道感染的病原菌主要以革兰阴性菌为主,病原菌对常用抗菌药物表现出一定的耐药性,临床应根据药敏试验结果合理选用抗菌药物,避免盲目用药。
OBJECTIVE To carry out the bile culture for the common bile duct stones patients complicated with biliary tract infections and statistically analyze the distribution and drug resistance of the pathogens so as to provide guidance for clinical use of antibiotics.METHODS A total of 120 patients with common bile duct stones who were treated in the hospital from Jan 2012 to Feb 2013 were recruited as the study objects.All the patients underwent the endoscopic retrograde cholangiopancreatography（ERCP）,the bile specimens were collected during the surgery,the bacterial culture was carried out,and the drug susceptibility testing was performed.RESULTS Of the 120 patients with common bile duct stones,96 were detected positive for the pathogens,with the detection rate of80.0%.Totally 107 strains of pathogens were isolated,including 75（70.1%）strains of gram-negative bacteria,30（28.0%）strains of gram-positive bacteria,and 2（1.9%）strains of fungi.The drug resistance rates of the Escherichia coli to imipenem,meropenem,and ciprofloxacin were less than 20.0%;the drug resistance rates of the Klebsiella pneumoniae to imipenem and meropenem were 0;the drug resistance rates of the Enterococcus faecalis to vancomycin,fosfomycin,and chloramphenicol were less than 10.0%.The fungi were highly susceptible to ketoconazole,itraconazole,nystatin,and amphotericin.CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the biliary tract infections in the patients with common bile duct stones.The pathogens show a certain degree of drug resistance to the commonly used antibiotics.It is necessary for the hospital to reasonably use antibiotics based on the results of the drug susceptibility testing so as to avoid the blind medication.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第17期3901-3902,3916,共3页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生计划基金资助项目(2011KYA011)
关键词
胆总管结石
胆道感染
病原菌
药敏分析
Common bile duct stone
Biliary tract infection
Pathogen
Drug susceptibility testing
