198例急性胆囊炎手术胆汁需氧菌培养与抗生素选用临床研究

Biliary Aerobic Bacteria Culture and Clinical Application of Antibacterias in 198 Patients Undergoing Acute Cholecystitis Surgery

目的:了解急性胆囊炎时胆汁中需氧菌感染及其对抗生素的敏感情况。方法:对2003～2007年本院外科送检的198例急性胆囊炎手术中采集的胆汁进行需氧菌培养和药敏试验。结果:198例胆汁标本中,有147例需氧菌检出阳性,其中为混合感染菌21例。共分离出225个菌株,其中大肠埃希菌占42.7%,肺炎克雷伯菌占22.7%,肠杆菌属占16.9%。药敏结果显示,所有菌存在不同程度耐药,头孢类抗生素敏感性较高;革兰阳性菌对万古霉素最为敏感;革兰阴性杆菌对亚胺培南最为敏感。结论:胆囊术中胆汁作细菌培养和药敏试验是必须的,临床应根据药敏试验结果合理选用抗生素。

OBJECTIVE： To investigate the biliary aerobic bacterial infection in acute cholecystitis and their susceptibility to antibacterials. METHODS： Biliary samples of 198 patients undergoing acute cholecystitis surgery in our hospital from 2003 to 2007 were sujected to culture of biliary aerobic bacteria and drug sensitivity test. RESULTS： Of the total 198 bile specimens, 147 were postive in aerobic bacteria culture, of which, 21 were mixed infection. A total of 225 strains were isolated, with Escherichia coli, Klebsiella pneumonia and Enterobacter representing 42.7%, 22.7% and 16.9% respectively. In the drug sensitivity, all the bacteria showed different degree of resistance to antibiotics, with cephalosporines showing the higest antibiotic sensitivity. Grampositive bacteria were the most sensitive bacteria to vancomycin while Gramnegative bacteria were the most sensitive bacteria to imipenem. CONCLUSION： Biliary bacterial culture and drug sensitivity test are necessary in acute cholecystitis surgery and drugs should be used according to the results of drug sensitivity test.