摘要
目的探讨胆石症(CL)患者胆汁中的病原菌分布、构成及药敏情况。方法选取行胆管手术的CL患者224例,采集胆汁标本,进行细菌种类鉴定和药敏试验。结果共分离到病原菌207株,其中革兰阴性菌166株(80.19%)、革兰阳性菌39株(18.84%)、真菌2株(0.97%)。最常见的病原菌依次为大肠埃希菌83株(40.10%)、铜绿假单胞菌37株(17.87%)、阴沟肠杆菌33株(15.94%)、肠球菌属29株(14.01%)。主要革兰阴性菌仅对亚胺培南100%敏感,此外大肠埃希菌和肺炎克雷伯菌对头孢哌酮/舒巴坦、阿米卡星的敏感率较高,铜绿假单胞菌和阴沟肠杆菌则对头孢吡肟、左氧氟沙星、阿米卡星的敏感率较高;主要革兰阳性菌对利奈唑胺100%敏感、对万古霉素高度敏感,此外肠球菌属对庆大霉素、葡萄球菌属对左氧氟沙星的敏感率也较高。结论 CL患者胆汁中的病原菌对大多数常用抗菌药物均产生了不同程度的耐药性,临床应根据药敏试验结果合理选用抗菌药物。
Objective To investigate the pathogens distribution and antibiotic resistance in patients with cholelithiasis （CL）. Methods 224 patients with CL were enrolled in the study.The bile samples were collected from these patients during the operations.Then the isolation and identification of pathogens and antibiotics susceptibility were tested. Results A total of 207 bacterial strains were isolated,including 166 Gram-negative （80.19%）,39 Gram-positive （18.84%） and 2 fungal strains （0.97%）.The top four strains are Escherichia coli 83 （40.10%）, Pseudomonas aeruginosa 37 （17.87%）, Enterobacter cloacae 33 （15.94%） and Enterococcus 29 （14.01%）, respectively.None of the main Gram-negative strains resisted to imipenem. Escherichia coli and Klebsiella pneumonia strains showed a higher susceptibility to cefoperazone/snlbactam and amikacin while Pseudomonas aeruginosa and Enterobacter cloacae strains showed a higher susceptibility to cefepime, levofloxacin and amikacin. None of the main Gram-positive strains resisted to linezolid.The main Gram-positive strains showed a high susceptibility to vancomycin.Besides,Staphylococcus strains to gentamycin and Staphylococcus to levofloxacin showed a lower resistance. Conclusion The pathogens in CL patients are generally resistant to the commonly used antibiotics. Antibiotics should be used reasonably basing on the results of the drug susceptibility testing.
出处
《基层医学论坛》
2017年第8期951-952,共2页
The Medical Forum
关键词
胆石症
病原菌
分布
药敏试验
Cholelithiasis Pathogen Distribution Susceptibility test
