417株临床胆汁分离细菌培养与药物敏感试验结果分析

Bacterial distribution of 417 bile-isolated strains and their drug susceptibilities

目的通过胆汁培养了解胆道感染病原菌分布和病原菌的药敏情况,为抗生素的合理使用提供参考依据。方法选取2010年1月至2011年12月西安交通大学医学院第一附属医院从临床患者胆汁标本中分离培养出的细菌,所有菌株均采用全自动微生物鉴定/药敏分析仪进行检测,世界卫生组织细菌耐药性监测网提供的WHONET 5.4软件进行数据统计分析。结果共分离出417株病原菌,其中革兰阴性菌占65.95%,革兰阳性菌占32.37%,真菌占1.68%。药敏结果显示革兰阴性杆菌中肠杆菌科细菌耐药率较低,铜绿假单胞菌与鲍曼不动杆菌耐药率均较高。革兰阳性球菌中葡萄球菌对利奈唑胺、万古霉素、替考拉宁均敏感,而肠球菌存在万古霉素耐药株。真菌未检出耐药菌。胆道感染病例中,仅分离出1种病原菌的病例比例为76.47%,2种细菌混合感染为22.94%,3种细菌混合感染为0.59%。结论胆道感染病原菌分布仍然以革兰阴性菌为主,但耐药严重。虽然单独感染仍为主要感染类型,但是重叠感染的病例需要得到重视。

Objective To investigate the bacterial distribution of bile-isolated strains and their drug susceptibilities to provide informations for rational use of antibiotics.Methods Bile cultures and antibiotic susceptibility tests were performed on the strains isolated in the First Affiliated Hospital of Xi＇an Jiaotong University.WHONET 5.4 was used for data analysis.Results A total of 417 bacterial strains were isolated,in which Gram negative strains accounted for 65.95%,Gram positive strains 32.37% and fungus 1.68%.The resistance of Enterobacteriaceae bacteria was lower,while that of Pseudomonas aeruginosa and Acinetobacter baumannii was higher.Staphylococcus was susceptible to linezolid,vancomycin and teicoplanin,while Enterococcus was resistant to vancomycin.No resistant fungi were found.In the cases of bile infection,those with only one pathogen accounted for 76.47%,while those with two and three pathogens accounted for 22.94% and 0.59% respectively.Conclusion The most common pathogens in bile infection were Gram negative strains with serious resistance.Although single pathogen infection was the main model in bile infection,multi-pathogen infection should also be paid more attention in clinical practice.