肝移植术后胆汁培养中的病原菌分布及耐药表型分析

Etiology from bile culture and drug-resistance in patients after liver-transplantation

目的对肝移植受者术后胆汁培养中的病原菌分布和耐药表型进行分析，为肝移植术后病原菌感染的临床预防和治疗提供参考。方法对274例肝移植受者术后胆汁标本的培养结果以及病原菌的药敏试验进行综合分析。结果274例胆汁标本培养结果显示，有195例标本的病原菌检验呈阳性，阳性率71．2％。共检出病原菌269株，其中阳性球菌168株，以肠球菌（117株）及凝固酶阴性葡萄球菌（50株）为主；阴性杆菌99株，以铜绿假单胞菌、不动杆菌和嗜麦芽窄食单胞菌为主；检出烟曲霉菌2株。无论阳性球菌还是阴性杆菌，都具有严重的多重耐药性。结论肝移植受者术后胆汁培养中病原菌的检出率高，耐药性强，耐药范围广。

Objective To study the pathogen and drug-resistance in bile specimens from patients after liver-transplantation and provide basis of choice of medicine and clinical prevention. Methods The results of bile culture of 274 patients after liver-transplantation and drug-resistance of the isolated bacteria were analyzed. Results A total of 195 positive specimens of the 274 cases were identified, accounting for 71%. 269 pathogens were cultured. Among positive specimens there were 168 strains of Gram-positive cocci, 117 strains of Enterococci and 50 strains of coagulase-negative staphylococci; 99 strains of Gram-negative bacilli, mainly Pseudomonas aeruginosa, Acinetobacter and Stenotrophomonas maltophilia. Positive specimens with more than 2 strains of bacteria accounted for 35%. Both the Gram-positive cocci and the Gram-negative bacilli were multi-drug resistant. Conclusion The bacterial detectabe rate from bile culture was high, and the bacteria had extensive and heavy drug-resist- ance after liver transplantation.