胆道感染细菌学检验与耐药性分析

Bacteriological examination and drug resistance analysis of biliary tract infection

目的了解胆道感染病原菌的种类及其对抗菌药物的耐药性,以指导临床用药。方法调查医院2009年9月-2011年9月收治的170例胆道感染患者,所有患者均通过抽取病变胆囊内胆汁4～6ml进行细菌培养以及药敏试验。结果 170例患者共培养出病原菌120株,检出率为70.6%;其中革兰阳性菌42株占35.0%;革兰阴性菌78株占65.0%;革兰阳性菌对青霉素类和喹喏酮类敏感率均>80.0%,对万古霉素敏感率为100.0%;革兰阴性菌对亚胺培南的敏感率为100.0%。结论胆道感染病原菌以革兰阴性菌为主,普通感染可选用喹喏酮类或氨基糖苷类抗菌药物,中、重度感染可选用头孢哌酮/舒巴坦或哌拉西林/他唑巴坦,严重感染可选用亚胺培南。

OBJECTIVE To understand the pathogens distribution in the biliary tract infections and their resistance to commonly used antibiotics,and provide reference for clinical practice.METHODS A total of 170 cases of patients with biliary tract infections from Sep 2009 to Sep 2011 in our hospital were analyzed,4-6 ml bile extraction were collected from each patient by intraoperative gallbladder for bacteria culture and drug susceptibility tests.RESULTS A total of 120 strains of pathogens were isolated from 170 patients with the detection rate of 70.6%.There were 42 strains of gram-positive bacteria,accounted for 35.0%;and the rest 78 strains were gram-negative which accounting for 65.0%.G＋ bacteria had more sensitive to penicillin and quinolone（80% susceptibility rate of or more）,and vancomycin was the most susceptible antibiotics（100% susceptible）.Imipenem was the most susceptible antibiotics to the G-bacteria（100% susceptible）.CONCLUSION Gram-negative bacteria were the predominnt pathogens of biliary tract infection.We can choose the antibiotics such as the quinolone or the aminoglycosides for normal infections,choose cefoperazone/sulbactam or piperacillin/tazobactam for moderate or severe infection,and choose imipenem for serious infection.