胆石病的胆汁病原菌培养及药敏分析

Bile pathogen detection and antibiotic drug sensitive test in patients with cholelithiasis

目的 了解胆石病胆汁病原菌菌谱和药敏反应情况。方法 应用微生物自动检测鉴定仪对 36 6例胆石病胆汁行病原菌鉴定和药敏检测。结果 36 6例胆汁标本常规培养阳性率为70 5 % ,2 5 8例阳性标本中检出需氧菌 2 6 8株 ,其中埃希大肠杆菌 12 1株 ,占需氧菌 4 5 2 % ,其次是肺炎克雷伯菌 (2 4 2 % ) ,肠球菌 (10 1% )。对其中 32例同时作厌氧菌培养 ,检出厌氧菌 14例 ,总检出率为 4 4 % ,以脆弱类杆菌最多 ,占厌氧菌的 5 7%。G阴性菌占需氧菌的 73%和厌氧菌的 86 %。需氧菌对亚胺培南、哌拉西林加他唑巴坦、丁胺卡那霉素敏感率分别为 94 % ,83% ,6 3%。厌氧菌对亚胺培南、哌拉西林加他唑巴坦的敏感率分别为 93%、86 %。结论 胆石病胆汁病原菌主要由大肠杆菌、肺炎克雷伯菌、肠球菌和脆弱类杆菌构成 ,胆汁致病菌最敏感的药物是亚胺培南和哌拉西林加他唑克坦。

Objective To understand the spectrum of bile pathogen in patients with cholelithiasis and their drug sensitivity to antibiotics.Methods Microbes automatic detection system was applied to detect the spectrum of bile pathogen and their drug sensitivities in 366 cholelithiasis patients who underwent choledochotomy. ResultAmong 366 specimen ,common cultures were positive in 258 (70 5%) in which 268 strains of aerobes were detected, and most of them were E.coli(121 strains,45 2%), Klebsiella pneumoniae (24 2%) and Enterococcus(10 1%). 14 strains of anaerobes were cultured in 32 specimen with an incidence of 44%,among which the most common type was B.fragilis (57%).Most pathogens in all the bile specimen were gram negative,73% in aerobes and 86% in anaerobes. Aerobes were highly sensitive to imipenem, tazobactam/piperacillin (TZP) and amikacin, with sensitive rate of 94%,83%, and 63%, respectively. The sensitive rate of anerobes to imipenem as well as TZP was 93% and 86% repectively. Conclusions The main pathogen in patients with cholelithiasis were Escherichia coli,Klebsiella pneumoniae, intestinal cocci and B.frailis which were most sensitive to those antibiotics such as imipenem and TZP.