287份胆汁细菌培养及药敏结果分析

Analysis of 287 cases bile′s germiculture and antibiotic susceptibility test

目的了解引起胆道感染的主要病源菌及其对药物的耐药性。方法对287例胆道病患者在手术中无菌引流胆汁进行细菌培养及药敏测试,其中有14份胆汁同时做了厌氧培养。结果287份胆汁中有168份标本培养出细菌;阳性检出率58.5%。共培养出细菌184株,其中革兰氏阴性杆菌112株(占60.8%);革兰氏阳性球菌68株(占36.9%);厌氧菌3株(占1.6%);真菌1株(占0.5%)。用K-B纸片扩散法做药敏分析,结果显示:大肠埃希菌和克雷伯菌对多种类药物都有不同程度的敏感性。除氨苄西林、磺胺耐药率67.5%-58.1%外,其余类药物耐药率均小于31%。而铜绿假单胞菌、其它非发酵菌、肠杆菌属及粪肠球菌和葡萄球菌则出现多重交叉耐药。对青霉素类、磺胺耐药率在80%,头孢类耐药率大于70%。结论胆道感染病原菌主要为大肠埃希氏菌、粪肠球菌、克雷伯菌、肠杆菌及其它链球菌。对三代头孢、哌拉西林、阿米卡星、庆大霉素及亚胺培南有较高敏感性。

Objective: To find out the main pathogenic bacteria and their resistant strain in cholangitis.Methods: 287 cases′ bile were collected, germiculture and antibiotic susceptibility test were carried out, 14 cases of those had been anaerobic cultivated at one time. Results: 168 cases had found out bacteria in 287 cases, positive rate was 58.5% and 184 kinds bacteria were found, G- 112(60.8%), G+ 68(36.9%); antibiotic 3(1.6%),epiphyte1 (0.5%). The result of antibiotic susceptibility with K-B method shows: Escherichia coli and klebsiella had susceptibility to many medicines to some degree. Beside ampicillin′s and sulfanilamide′s resistant strain rate was 67.5%~58.1%, all others′ were less than 31%. Mucor racemosus, other non-zymogen, intestines bacilli and group entercoccus, staphylococcus appeared multi-acrossed medicine resistant. 80% of those bacteria resistanted picilline and sulfanilamide, 70% resistanted cephalosporin. Conclusion: the main pathogenic bacteria in cholangitis are Escherichia coli, group entercoccus, klebsiella, intestines bacilli and other streptococcus and have high susceptibility to cefobid Fortum, Piperacillin, Amikin, Gentamycin and Tienam.