闽北地区肝胆管结石细菌感染耐药情况分析

Bacteria resistance analysis of bile duct infections in patients with bile duct stones in northern Fujian

目的探讨闽北地区肝胆管结石患者胆汁的细菌谱及细菌药物敏感性状况。方法对我院自2008年7月—2012年7月收治的330例肝胆管结石的患者进行胆汁细菌培养及药物敏感性试验,并对收集的资料进行统计学分析。结果 330例患者中198例培养阳性,阳性率为60%。共培养菌株207株,其中G-菌126株,占60.9%,G+菌81株,占39.1%。引起胆道感染较为常见的菌属依次为大肠埃希菌属、粪肠球菌属、肺炎克雷伯菌属、铜绿假单胞菌属。G-菌对头孢他啶、头孢哌酮钠-舒巴坦钠、亚胺培南、阿米卡星敏感性较高,G+菌对氨曲南、亚胺培南敏感性较高。结论随着闽北地区各种抗菌药的广泛应用,肝胆管感染细菌谱发生了一定变化,G+菌比例虽有所上升,但G-菌仍占较高比例,且细菌对抗菌药的耐药性有所上升,临床应根据培养结果合理应用抗菌药。

Objective To explore bacterial spectrum and resistance of the bile from patients with bile duct stones in northern Fu- jian. Methods The bile from 330 patients with bile duct stones in our hospital from July 2008 to July 2012 was subjected to bacte- rial culture and drug susceptibility test, and the data were statistically analyzed. Results Of the 330 patients, 198 got a positive- culture with a positive culture rate of 60%. Of the 207 strains of bacteria cultured, G- accounted for 60.9% （ 126 strains） and G ＋ accounted for 39.1% （81 strains）. The most common pathogens of bile duct infection were Escherichia coli genus, Enterococcus faecalis,Klebsiella pneumoniae, Pseudomonas aeruginosa genus. G- bacteria were more sensitive to Ceftazidime, Cefoperazone sodiurrdSulbactam sodium, Imipenem and Amikacin, while G ＊ bacteria were more sensitive to Aztreonam and Imipenem. Conclusion With the various antibiotics were widely used in northern Fujian, bacterial spectrum of bile duct infection has changed. Proportion of G ＋ bacteria increased, but G - bacteria still accounts for a higher proportion. Resistance to antibiotics of bacteria has been increasing, so rational clinical use of antibiotics should be based on culture results.