胆管恶性肿瘤患者胆汁细菌学分析

Investigation of bile bacteria in patients with cholangiocarcinoma

目的:探讨胆管癌胆汁中的细菌分布及特征。方法:对西安交通大学医学院第二、第三附属医院2011年11月至2012年10月期间诊断为胆管癌患者的胆汁进行细菌培养并分析。结果:共106例患者的胆汁纳入研究,57.5%的胆汁标本细菌培养呈阳性。部分无感染及胆道梗阻的胆汁中仍有部分存在细菌,但细菌检出率较有感染以及胆道梗阻者明显减低,而肿瘤位置同细菌的检出率之间并无统计学关联。许多种细菌可出现在胆汁中,常见细菌依次为肠球菌属、大肠埃希菌、葡萄球菌属、肺炎克雷伯菌、铜绿假单胞菌等。而万古霉素、莫西沙星、亚胺培南等多种抗生素均对细菌具有良好的敏感性。结论:胆管癌患者无论是否存在感染及梗阻,胆汁内都有可能存在细菌,细菌的检出率同肿瘤部位无关。而肠道菌群仍是胆道细菌的主要来源。

Objective：To investigate the distributeion and character of bile in patients with cholangiocarcinoma. Methods： Obtained the bile from patients who were diagnosed as cholangioearcinoma between November 2011 and October 2012. The bile specimens were cultured and analyzed. Results： The bile of 106 patients was included and 57.5% patients were found bacterial growth by culture. Some patients without infection or bile duct obstruction also showed positive result by bacterial culture, however, this result was lower than the patients with infection or bile duct obstruction. On the other hand ,we also found that there wasnt statistic relationship between the positive rate of bacte- rial culture and location of tumor. Many kinds of bacteria were identified in the bile and most common bacteria were as follow ： anterococeus, eseheriehia coli, staphylococcus, klebsiella pneumoniae, pseudomonas aeruginosa, etc. Several an- tibiotics showed satisfied sensitivity to the bacteria such as vancomycin, moxifloxaein, imipenem, etc. Conclusion： Bacteria may present in bile whether the patients have or not have infection or bile duct obstruction, and the positive rate of bacterial culture isnt related to the location of tumor. The intestinal mierobiota is the mainly bacteria source of bile.