胆道感染240例胆汁细菌培养结果及药敏分析

Analysis of bacteria culture and antibiotic susceptibility test in 240 patients with biliary tract infection

目的了解引起胆道感染的主要病原菌及其对药物的耐药性。方法对我院自2007年1月至2008年12月收治的240例胆道感染病人术中取胆汁进行细菌培养及药敏分析。结果240份胆汁标本中130份培养阳性,培养阳性率为54.2%。共分离出细菌150株,其中革兰阴性杆菌95株,革兰阳性球菌55株。引起胆道感染的主要病原菌依次为铜绿假单胞菌(26.7%)、大肠埃希菌(18.7%)、肠球菌(14.6%)和克雷伯菌(10.0%)。药敏结果显示,革兰阴性杆菌对亚胺培南、美罗培南、头孢吡肟及阿米卡星(丁胺卡那霉素)耐药率较低;革兰阳性球菌对万古霉素、替考拉宁、阿米卡星及头孢哌酮耐药率较低。结论胆道感染仍以革兰阴性杆菌为主,其中铜绿假单胞菌位居首位;阿米卡星可作为治疗胆道感染的首选用药之一。

Objective To find out the main pathogenic bacteria and their resistant strain in cholangitis. Methods The bile from 240 patients with biliary tract infection during Jan. 2007 and Dec. 2008 were subjected to biliary gemiculture and sensitivity to antibiotics. Results The 130 patients with positive bile bacteria culture belonged to 240 of bile（54. 2 %, 130/240）. A total of 150 strains were identified, including 95 Gram negative strains, 55 Gram positive strains. The common pathogenic bacteria were Pseudomonas aeruginosa （ 26. 7 % ）, Escherichia coli（ 18. 7 % ）, Enterococcus （ 14. 6 % ） and Klebsiella（10. 0 %）. Drug sensitivity test indicated that Gram negative strains were sensitive to imipenem, meropenem, cefepime and amikacin, and so as Gram positive strains to vancomycin, teicoplanin, amikacin and cefoperazone. Conclusion Gram negative strains remains the common in biliary tract infection. Among them, the dominant position of Pseudomonas aeruginosa. Amikacin may be the medicine selected first to treat biliary tract infection.