胆道感染病原菌对抗菌药物的敏感性分析研究

Pathogens causing biliary tract infection and their sensitivity to antibiotics

目的分析胆道感染患者胆汁中病原菌的分布及对抗菌药物的药敏率,为临床合理用药提供依据。方法回顾性分析2005-2009年接受胆道手术治疗的患者于术中所取胆汁标本进行病原菌培养及药敏试验结果。结果 521株病原菌中革兰阴性杆菌380株(72.94%),革兰阳性球菌136株(26.10%);引起胆道感染的常见病原菌依次为大肠埃希菌、肺炎克雷伯菌、粪肠球菌、铜绿假单胞菌和屎肠球菌等;革兰阳性菌对替考拉宁、万古霉素敏感率最高,均为100.00%;革兰阴性菌中大肠埃希菌和肺炎克雷伯菌对亚胺培南敏感率最高,敏感率分别为99.36%、98.75%,铜绿假单胞菌对阿米卡星敏感性最高(80.70%)。结论胆道感染中革兰阴性菌仍占主要地位,但是革兰阳性球菌比例明显升高;临床治疗应依据药敏试验结果合理选用抗菌药物,降低病原菌耐药性,提高治愈率。

OBJECTIVE Analyze the distribution of pathogen in biliary tract infection and their sensitivity to antibiotics so as to guide the rational use of antibiotics. METHODS The data of 521 strains of pathogens which were collected from biliary tract infection from Jul 2005 to Jun 2009 were retrospectively analyzed and their sensitivity to antibiotics were also analyzed. RESULTS A total of 521 strains, 72. 94% of which were Gram negative bacilli and 26. 10 % of which Were Gram positive ones. The most common pathogenic bacteria were Escherichia coli , Klebsiella pneumoniae , Enterococcus f aecalis , Pseudomonas aeruginosa and Enterococcus f aecium. The results of drug susceptibility showed that Gram-positive bacteria were 100.00% sensitive to vancomycin and teicoplanin. Among the Gram negative bacilli, 99.63% of E. coli and 98.75M of K. pneumoniae were sensitive to imipenem. P. aeruginosa was sensitive to amikacin. CONCLUSIONS Gram negative strains are most common in biliary tract infection, but the rate of Gram positive strains is obviously rising. Antibiotic should be selected based on the sensitivity test results in order to reduce bacterial resistance and improve the cure rate.