胆道感染病原菌调查与耐药性分析

Clinical Research on Pathogenic Bacteria of Biliary Infection and Their Resistance to Antibiotics

目的 :了解胆道感染胆汁中的主要致病菌及其耐药情况 ,指导临床合理用药。方法 :对 1999年 1月～ 2 0 0 0年 12月期间我院 40 3例胆道感染胆汁细菌培养阳性的 481株致病菌的分布情况及其耐药结果作回顾性分析。结果 :481株胆汁培养阳性的病原菌中革兰阴性杆菌 371株 (77.1% ) ,其中大肠埃希菌 114株 (2 3.7% ) ,肺炎克雷伯菌 92株 (19.1% ) ;革兰阳性球菌 10 3株 (2 1.4% ) ,其中肠球菌 71株 (14.8% ) ;真菌属 7株 (1.5 % )。革兰阴性杆菌对头孢他啶和亚安培南的耐药率为 2 1.1%和8.89% ,革兰阳性球菌对亚安培南和万古霉素的耐药率为 2 4.3%和 7.77%。结论 :胆道感染主要病原菌是大肠埃希菌 ,肺炎克雷伯菌和肠球菌。

Objective: The aim of this study was to analyse the pathogenic bacteria of biliary infection and their resistance to antibiotics. Methods: Between January 1999 and December 2000, 481 pathogenic bacteria of biliary infection(403 patients) and their resisitance to antibiotics were studied retrospectively. Results: In regard to 481 pathogenic bacteria with positive biliary culture, 371(77.1%) were gram-negative bacilli, of which 114(23.7%) were Escherichia coli,92(19.1%) were Klebsiella pneumoniae.103(21.4%) were gram-positive cocci, of which 71(14.8%) were intestinal cocci. 7(1.5%) were fungi. Gram-negative bacilli was sensitive to ceftazidine and imipenem with low resistance rate of 21.1% and 8.89%.Gram-positive cocci was sensitive to imipenem and vancomycin with resistance of 24.3% and 7.77%. Conclusion: The main pathogenic bacteria of purulent cholangitis were Escherichia coli, Klebsiella pneumoniae and intestinal cocci. Ceftazidine and/or imipenem may be the first medicine to treat biliary infection.