胆道引流液分离的病原菌及药敏分析

Distribution and antimicrobial susceptibility of pathogens from biliary drainage

目的了解胆道引流液分离的常见病原菌分布及药敏特点,为指导临床合理用药提供依据。方法对2012年1月到2015年12月的327例胆道感染患者胆道引流液标本进行病原菌培养及药敏试验进行分析。结果 327份胆道引流液标本中,培养出细菌的标本有241例,占73.70%;共分离出病原菌365株,其中革兰氏阴性菌(G-)235株(64.38%),革兰氏阳性菌(G+)103株(28.22%),真菌27株(7.40%)。有102份(31.19%)标本培养出2种病原菌,11份(3.36%)标本培养出3种病原菌。肠杆菌科细菌中较多见的依次为大肠埃希菌、肺炎克雷伯菌、变形杆菌属、产酸克雷伯菌;非发酵菌中较多见的依次为铜绿假单胞菌、不动杆菌属、嗜麦芽窄食单胞菌。革兰氏阳性菌以屎肠球菌多见,粪肠球菌次之。结论胆道感染的病原菌种类有增加的趋势,但仍以革兰氏阴性菌为主。

Objective To observe the distribution and antimcirobial susceptibility of pathogens from biliary drainage fluid of patients,and provide guideline for clinical antimcirobial use. Methods Antimicrobial susceptibility test for strains isolated from bile culture were performed in327 biliary drainage fluid samples from Jan 2012 to Dec 2015. Results There were 241 cases of bacterial culture in 327 biliary drainage samples,accounting for 73. 70%. A total of 365 bacterial strains were isolated, including gram- negative bacilli 235 strains, accounting for64. 38%,gram- positive cocci 103 strains,accounting for 28. 22%,fungi 27 strains,accounting for 7. 40%. Two and 3 pathogens were isolated simultaneously from 102（ 31. 19%） and 11（ 3. 36%） samples. The top four Enterobacteriaceae bacilli were Escherichia coli,Klebsiella pneumoniae,Proteus and Klebsiella oxytoca. The top three non- fermentive bacilli were Pseudomonas aeruginosa, Acinetobacter baumannii and stenotrophomonas maltophilia. The top two gram- positive cocci were Enterococcus faecium and Enterococcus faecalis. Conclusion The types of pathogens causing biliary tract infections are becoming diverse,but gram- negative bacilli still account for the majority.