摘要
目的探究急性胆源性胰腺炎患者胆汁中主要致病菌与敏感抗菌药物及相关因素。方法选择2015年9月至2017年9月急性胆源性胰腺炎患者共176例作为研究对象,抽取胆汁进行细菌培养和抗菌药物敏感性实验,并比较不同梗阻部位和总胆红素水平与细菌检出率见的关系。结果细菌培养为阳性检出率为68.18%。其中需氧菌155株,厌氧菌25株。G-菌中最多为大肠埃希菌(62.85%),G+菌中最多为肠球菌属(12.26%),厌氧菌最多为脆弱类杆菌(52.00%)。G-菌对于美罗培南、头孢吡肟以及环丙沙星的敏感率大于80%,分别为96.77%、91.13%以及84.68%。G+对于万古霉素的敏感率为100%,对于美罗培南、四环素和阿奇霉素的敏感率高于80%。高位梗阻的细菌培养阳性率显著高于中低位梗阻(P<0.05)。低水平组显著高于中水平组和高水平组(P<0.05),中水平组显著高于高水平组(P<0.05)。结论对于ABP患者的早期抗感染治疗可根据检出致病菌选择相应药物治疗,对于高位梗阻和低TB水平的患者需加强抗感染治疗。
Objective To explore the main pathogenic bacteria and sensitive antibiotics and related factors in bile in patients with acute biliary pancreatitis(ABP).Methods 176 patients with ABP from September 2015 to September 2017 were selected as the study subjects.Bile was collected for bacterial culture and antibiotic susceptibility testing.The relationship between different obstruction sites and total bilirubin levels and bacterial detection rates was compared.Results The positive rate of bacterial culture was 68.18%.There were 155 aerobic bacteria and 25 anaerobic bacteria.Among the G-bacteria,E.coli(62.85%)accounted for the largest proportion,Enterococcus(12.26%)accounted for the highest proportion of G+bacteria,and Bacteroides fragilis(52.00%)accounted for the majority of anaerobes..The sensitivity of G-bacteria to meropenem,cefepime and ciprofloxacin was greater than 80%,which was 96.77%,91.13%and 84.68%,respectively.The sensitivity rate of G+to vancomycin was 100%,and the sensitivity rate to meropenem,tetracycline,and azithromycin was higher than 80%.The positive rate of bacterial culture in high obstruction was significantly higher than that in middle-low obstruction(P<0.05).The low-level group was significantly higher than the middle-level group and the high-level group(P<0.05),and the middle-level group was significantly higher than the high-level group(P<0.05).Conclusion For the early anti-infection treatment of ABP patients,aminoglycosides+third-generation cefquinolones+metronidazole can be used for treatment.Patients with high obstruction and low TB levels need to strengthen anti-infection treatment.
出处
《国际检验医学杂志》
CAS
2019年第3期321-324,共4页
International Journal of Laboratory Medicine
关键词
急性胆源性胰腺炎
药敏分析
抗菌药物使用
acute biliary pancreatitis
drug susceptibility analysis
antibiotic use
