肝外阻塞性黄疸患者胆汁病原菌检测及其耐药性研究

RESEARCH ON BACTERIAL DETECTION OF BILE FROM PATIENTS WITH EXTRA-HEPATIC OBSTRUCTIVE JAUNDICE AND ANALYSIS OF DRUG RESISTANCE

目的研究肝外阻塞性黄疸患者胆汁病原菌分布及其耐药性的变化,为临床合理用药提供参考。方法采用细菌分离鉴定技术和药敏试验方法,对某医院235例肝外阻塞性黄疸住院患者胆汁标本进行了病原学检测。结果235例患者送检胆汁标本中,有201例检出病原菌,检出率为85.53%,共培养出病原菌243株。在检出的病原菌中,革兰阴性菌占71.20%,革兰阳性菌占25.51%,真菌占3.29%。革兰阴性菌对亚胺培南、美罗培南、厄他培南等抗菌药物比较敏感,对多数抗菌药物不同程度耐药;革兰阳性菌对万古霉素、替考拉宁、利奈唑胺耐药率较低。结论肝外阻塞性黄疸患者胆道系统多数存在感染,病原菌检出率较高,各种病原菌对抗菌药物均有不同程度的耐药。

Objective To investigate the distribution of pathogenic bacteria and their changes of drug - resistance in bile collected from extra - hepatic obstructive jaundice patients. Methods The bile of patients with extrahepatic biliary obstructive jaundice was collected under ERCP. The etiological examination was performed using bacteria isolation and identification technique and drug sensitivity test. Results 85.53% （201/235） bile specimens were cultured positively for bacteria. A total of 243 strains of pathogenic bacteria were cultured, where the Gram - negative bacteria accounted for 71.20%, Gram - positive bacteria accounted for 25.51%, and fungi accounted for 3.29%. The drug resistance rates of gram - negative bacteria to Imipenem, Meropenem and Ertapenem was the lower. The gram - positive cocci had low drug resistance rate to Vancomycin, Teicoplanin and Linozulam. Conclusion Most of patients with extra - hepatic obstructive jaundice have bile bacterial infection. Pathogen detection rate of bile is the higher. Different bacteria have variable resistance to antimicrobials.