摘要
目的分析胆囊炎及胆管炎患者胆汁中致病菌的特征及药物过敏情况,以便为此后的实际临床研究提供更多的参考依据。方法收集2015年10月—2016年10月该院收治的472例胆囊炎及胆管炎患者的胆汁标本,进行细菌培养,并利用全自动微生物系统鉴定致病菌的特征及药敏情况。结果胆汁标本共分离出311株非重复细菌,其中真菌占据3.2%;由粪肠球菌及屎肠球菌引起的革兰阳性细菌占据32.5%;由大肠埃希菌及肺炎克雷伯菌引起的格兰阴性细菌占据64.3%。且这些致病菌的药敏情况为:大肠埃希菌对替加环素、阿米卡星、头孢替坦以及头孢他啶等抗生素的敏感率在80.0%以上;肺炎克雷伯菌对环丙沙星及左氧氟沙星的敏感度分别为76.5%与80.0%。在肺炎克雷伯菌及阴沟肠杆菌中检测出了碳青霉烯菌的耐药株,且替加环素与万古霉素等抗生素对粪肠球菌及屎肠球菌的体外活性较强。结论革兰阴性细菌是胆道分离菌中的主要组成部分,尤其在大肠中最为常见,且可以利用头孢菌素治疗革兰阴性菌,利用替考拉宁药物治疗革兰阳性细菌。
Objective To analyze the bacteriology characteristics of bile bacterial isolates of patients with cholecystitis and angiocholitis and drug sensitivity thus providing more reference for the practical clinical research in future. Methods The bile specimens of 472 cases of patients with cholecystitis and angiocholitis admitted and treated in our hospital from October 2015 to October 2016 were collected for bacterial culture, and the pathogenic bacterial features and drug sensitivity were identified by the fully automated microbial system. Results 311 strains of nonrepeated bacteria were isolated by the bile specimens, the funguses accounted for 3.2%, the grampositive bacteria caused by the Enterococcus faecalis and enterococcus faecium accounted for 32.5%, the gramnegative bacteria caused by E.coli and klebsiella pneumoniae accounted for 64.3%, and the sensitivity rate of E.coli to prostacyclin, amikacin, ceftazidime and ceftazidime was above 80.0%, the sensitivity degree of klebsiella pneumoniae to ciprofloxacin and levofloxacin was respectively 76.5% and 80.0%, the drugresistant strains of carbapenem bacteria were tested in the klebsiella pneumoniae and enterobacter cloacae. Conclusion The gramnegative bacteria are a major component of bile bacterial isolates, especially in intestinum crissum, and we can treat the gramnegative bacteria by cephalosperin N and treat the grampositive bacteria by teicoplanin drugs.
出处
《系统医学》
2017年第4期40-42,共3页
Systems Medicine
关键词
胆囊炎
胆管炎
胆汁分离
细菌学特征
药敏分析
Cholecystitis
angiocholitis
Bile isolation
Bacteriology characteristics
Analysis of drug sensitivity
