普外科胆管手术患者细菌感染分布特征及药敏分析

Bacterial infection distribution characteristics and drug sensitivity analysis of patients undergoing biliary tract surgery ingeneral surgery

目的探讨普外科胆管手术患者细菌感染分布特征及药敏情况,为临床合理使用抗菌药物提供重要参考。方法选取2017年1月—2020年12月清远市人民医院行胆管手术治疗的100例患者作为研究对象,术中均无菌操作下抽取5 mL胆汁作为送检标本。统计病原菌分布情况,并对主要病原菌进行耐药性分析。结果100例普外科胆管手术患者共分离出66株细菌,其中革兰阴性菌48株,占比72.73%;革兰阳性菌18株,占比27.27%。大肠埃希菌、肺炎克雷伯菌及阴沟肠杆菌对亚胺培南、美罗培南耐药性最低,大肠埃希菌对左氧氟沙星耐药性最高,肺炎克雷伯菌对环丙沙星耐药性最高,阴沟肠杆菌对氨苄西林耐药性最高;肠球菌属、表皮葡萄球菌、金黄色葡萄球菌对利奈唑胺、万古霉素耐药性最低,肠球菌属对四环素耐药性最高,表皮葡萄球菌对红霉素、四环素耐药性最高,金黄色葡萄球菌对红霉素耐药性最高。结论胆管手术患者体内病原菌分布以革兰阴性菌为主,其次为革兰阳性菌,且两类病原菌耐药现象均较为严重,临床需依据药敏试验结果选取适宜抗菌药物,并提高临床合理用药意识,以减少耐药菌产生。

Objective To investigate the distribution characteristics and drug sensitivity of bacterial infections in patients undergoing biliary tract surgery in general surgery,and to provide important references for the rational use of antimicrobials in clinical practice.Methods A total of 100 patients who underwent biliary tract surgery in our hospital from January 2017 to December 2020 were selected as the research objects. During the operation,5 m L of bile was taken as the specimen for examination under aseptic operation.Count the distribution of pathogens and analyze the resistance of the main pathogens.Results A total of 66 strains of bacteria were isolated from 100 patients undergoing biliary tract surgery in general surgery,of which 48 were Gram-negative bacteria,accounting for 72.73%;18 Gram-positive bacteria,accounting for 27.27%;Escherichia coli,Cree pneumoniae Burberry and Enterobacter cloacae have the lowest resistance to imipenem and meropenem;Escherichia coli has the highest resistance to levofloxacin,Klebsiella pneumoniae has the highest resistance to ciprofloxacin,and Enterobacter cloacae has the highest resistance to levofloxacin Ampicillin has the highest resistance;Enterococcus,Staphylococcus epidermidis,and Staphylococcus aureus have the lowest resistance to linezolid and vancomycin;Enterococcus has the highest resistance to tetracycline,and Staphylococcus epidermidis is resistant to erythromycin,Tetracycline has the highest resistance,and Staphylococcus aureus has the highest resistance to erythromycin.Conclusion The distribution of pathogenic bacteria in patients undergoing biliary tract surgery is mainly gram-negative bacteria,followed by gram-positive bacteria. The drug resistance of the two types of pathogenic bacteria is relatively serious. It is necessary to select appropriate antibacterial drugs based on the results of drug susceptibility tests and improve clinical practice. Reasonable medication awareness to reduce the generation of drug-resistant bacteria.