胆道感染患者的病原菌分布及耐药性分析

Distribution and drug resistance of Pathogenic bacteria in patients with biliary tract infection

目的了解胆道感染患者的病原菌分布及耐药性特点,指导合理用药。方法送检标本275例,菌种分离培养和药物敏感试验执行《全国临床检验操作规程》(第3版)标准;分析仪器采用全自动微生物(VITEK-32法国)分析仪鉴定,用K-B法进行药物敏感试验,操作规程执行《全国临床检验操作规程》,结果判断执行美国临床实验室标准化研究所(CLSI)标准。结果送检标本275份,检出病原菌183株,检出率为66.55%;其中革兰阴性菌95株,占51.91%,革兰阳性菌63株,占34.43%,真菌12株,占6.56%;大肠埃希菌、肺炎克雷伯菌对亚胺培南/西司他丁的耐药率为0,粪肠球菌、屎肠球菌、葡萄球菌属对喹诺酮类耐药率较低。结论胆道系统感染的病原菌分布广泛且变化较大,有些菌株产生多药耐药性;建议临床医师重视监测病原菌菌群动态分布和药敏变化,用药敏结果指导临床合理用药,才能取得良好效果。

OBJECTIVE To study the mierobiologed distribution of biliary tract infection in patients with resistant strains so as to guide rational drug use. METHODS There were 275 cases with submission sample. The isolation and culture of bacteria and drug susceptibility test were executed according to National Clinical Laboratory Operating Procedures＇ （third edition） standards using automated microbial （VITEK-32, France） analyzer. KB method was used for drug susceptibility testing and the results were judged by Clinical Laboratory Standards （CLSI） standards. RESULTS A total of 183 strains were detected from 275 samples, with the detection rate of 66.55 ;. They included 95 strains of gram-negative bacteria accounting for 51.91M, 63 strains of gram-positive bacteria accounting for 34.43M and 12 strains of fungi accounting for 6.56M. The resistance rates of the major bacteria Escherichia coli and Klebsiella pneumoniae to imipenem/cilastatin was 0, and the resistance rate of Enterococcus faecalis, Enterococci feces, Staphylococcus aureus to quinolones was low. CONCLUSION The biliary system is widely distributed with microbial infections, and some strains may cause multidrug resistance. We suggest clinicians emphasize the monitoring of the dynamic distribution of pathogenic bacteria and changes in drug susceptibility to guide rational antibiotics use.