对常见的肝胆感染性疾病患者体内病原菌的分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria in hepatobiliary common infectious diseases

目的:探讨常见的肝胆感染性疾病患者体内病原菌的分布情况及耐药性,为临床上合理地使用抗菌药物治疗该病提供参考依据。方法:选取近几年我院肝胆外科送检的191例体液标本作为研究对象。对这些标本进行细菌鉴定,并对检出率较高的病原菌的耐药性进行分析。观察此类患者病原菌的分布情况及主要病原菌的耐药性。结果:经检验,在这191例标本中,共检出191株病原菌。其中有85.3%的革兰阴性菌(G-),有14.7%的革兰阳性菌(G+)。在G-中,大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌的检出率较高。大肠埃希菌对阿卡米星、阿莫西林/克拉维酸、亚胺培南、哌拉西林/他唑巴坦和替卡西林/棒酸的耐药率较低,对氨苄青霉素等常用抗菌药物的耐药率均较高。肺炎克雷伯菌除对亚胺培南的耐药率较低外,对氨苄青霉素等常用抗菌药物的耐药率均较高。铜绿假单胞菌对常用的抗菌药物都存在一定的耐药性,无相对敏感的药物。结论:常见的肝胆感染性疾病患者体内的病原菌主要是大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌等G-。这些病原菌对常用抗菌药物的耐药性较高。临床医师应根据患者感染的病原菌及病原菌的耐药性合理地使用抗菌药物。

Objective： To understand the pathogenic bacteria distribution and drug resistance status about hepatobiliary common infectious diseases of my hospital so as to provide reference for clinical rational use of antibiotics. Methods： Collected the specimen of hepatobiliary common infectious diseases in my hospital, then identified the bacterial species and analysed drug susceptibility. Results： There were 191 bacterial strains（gram-negative bacteria accounts for 85.3% while gram-positive bacteria accounts for 14.7%）. The most common species were Escherichia coli, Klebsiella pneumoniaean,Pseudomonas aeruginosa, which were all gram-negative bacteria. The drug resistance of three bacteria on the above shows that the resistance rates of Escherichia coli to amikacin,amoxicillin/clavulanic,piperacillin/tazobactam and ticarcillin /clavulanic acid were lower（3.9%~11.8%）,but more than 52.9% of resistance rates to other used antibiotic drug. The resistance rate of Klebsiella pneumonia to imipenem was lower（10.0%）,but with 23.3%~83.3% of resistance rates to other used antibiotic drug. Pseudomonas aeruginosa had some resistance to all commonly used antibiotic drug, no relative sensitive drug. The resistance rate to imipenem has been reached 23.3%.Conclusions：The pathogenic bacteria in hepatobiliary common infectious diseases are mostly gram-negative bacteria. The resistance rates to commonly used antibiotic drug are higher. We need strengthen the monitoring of pathogenic bacteria distribution and drug resistance status in hepatobiliary common infectious diseases so as to guide the rational use of antimicrobial agents for clinicians.