某院普外科胆道细菌感染及耐药性分析

Analysis of biliary bacterial infection and drug resistance in the general surgery department of certain hospital

目的分析该院普外科胆道疾病患者胆汁培养病源菌及其对常用抗菌药物的耐药性,以指导胆道感染性疾病的抗菌药物使用。方法回顾性分析2008年1月至2011年12月期间接受胆道手术的患者在术中所取胆汁进行培养的病原菌及药敏试验结果。结果 378例胆汁培养有细菌生长291例,阳性率为76.98%,分离出病原菌332株,主要以革兰阴性(G-)杆菌为主,分离出G-杆菌287株,占86.45%;革兰阳性(G+)球菌45株,占13.55%。前5位病原菌分别为大肠埃希氏菌、肺炎克雷伯菌、阴沟肠杆菌、肠球菌属、铜绿假单胞菌;G-杆菌除对左氟沙星、亚胺培南有较高的敏感性外,对其他常用抗菌药物均有较高的耐药性;G+球菌对万古霉素仍保持较高敏感性。结论胆道感染病原菌中以G-杆菌为主,产超广谱β内酰胺酶阳性率较高,胆道感染细菌多重耐药严重。

Objective To analyze the pathogen cultured from the biles of biliary disease patients in general surgery department of the hospital and its drug resistance to common antibiotics, in order to guide the use of antibacterial drug to biliary tract infectious disease. Methods To retrospectively analyze the results of pathogen culture of the biles from the biliary disease patients during the operation from January 2008 to December 2011 as well as its drug sensitivity results. Results Among 387 cases of bile samples, there were 291 cases with bacteria growth, and the positive rate was 76. 98%. 332 isolates of pathogen were separated, including 287 isolates of Grain negative bacilli（86.45 % ） and 45 isolates of Gram positive coccus（13.55 %）. The top 5 pathogen were Esche- riehia eoli, Klebsiella pneumoniae, Enterobaeter cloacae, Enterococeus, and Pseudomonas aeruginosa. Gram negative bacilli had high drug resistant rates to common antibiotics except for levofloxacin and imipenem. Gram positive coccus were still highly sensi- tive to vancomycin. Conclusion Gram negative bacilli was the main pathogen in biliary infection, with a high positive rate of ES- BLs. Biliary tract infectious bacteria had serious multiple resistance.