胆道感染的病原菌及药物敏感性研究

Pathogens causing biliary tract infections and analysis of drug susceptibility

目的研讨胆道感染的病原菌及其药物敏感性,为临床治疗提供用药依据。方法对医院2009年1月-2012年1月培养阳性的胆汁标本的病原菌分布及药物敏感性进行回顾性分析。结果共分离病原菌93株,其中革兰阴性杆菌41株占44.1%,革兰阳性球菌35株占37.6%,真菌13株占14.0%,排名前3位的病原菌依次为肠球菌属、大肠埃希菌、白色假丝酵母菌,分别占34.4%、26.9%、10.8%;肠球菌属对万古霉素高度敏感,大肠埃希菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦高度敏感,白色假丝酵母菌对氟康唑、伊曲康唑耐药率较高,对酮康唑、两性霉素B、制霉菌素敏感率均为100.0%。结论肠球菌属和大肠埃希菌是医院胆道感染最常见的病原菌,且细菌耐药严重,因此,应加强胆汁细菌检测,以便选择敏感的抗菌药物,缓解细菌耐药在胆道病原菌感染患者的发生和发展。

OBJECTIVE To study the pathogens causing biliary tract infections and analyze the drug susceptibility soas to guide the medication for the clinical treatment. METHODS The distribution and drug susceptibility of thepathogens isolated from the bile specimens from Jan 2009 to Jan 2012 were retrospectively analyzed. RESULTS To-tally 93 strains of pathogens were isolated, including 41 （44. 1%） strains of gram-negative bacilli, 35 （37. 6%）strains of gram-positive bacteria,and 13（14. 0%） strains of fungi. The Enterococci, Escherichia coli,and Candi-da albicans ranked the top three species of pathogens, accounting for 34. 4.%,26. 9% , and 10. 8%. respectively. The result of drug susceptibility testing showed that the Enterococci was highly sensitive to vancomycin？ the E.coli was highly sensitive to imipenem, amikacin, piperacillin/tazobactam, and cefoperazone/ sulbactam, and theCandida albicans was highly resistant to fluconazole and itraconazole, with the drug susceptibility rate of 100. 0%to ketoconazole , amphotericin, and nystatin. CONCLUSION The Enterococci and E. coli are the most common species of pathogens causing biliary tract infections and are highly resistant, therefore, it is necessary to strengthenthe detection of pathogens isolated from the bile so as to choose susceptible antibiotics and prevent the bacterial re-sistance in the patients with biliary tract infections.