胆道病患的细菌培养及耐药率变迁

Bacterial culture and drug resistance changes in patients with biliary tract diseases

目的探讨胆道疾病患者感染病原菌分布和耐药趋势变化。方法回顾性分析2019年1月-2022年12月在浙江省舟山医院检验中心微生物实验室培养的胆汁阳性结果,研究胆道疾病患者感染病原菌分布和药敏试验结果分析。结果2019年-2022年从胆汁标本共分离病原菌1611株,革兰阳性菌251株(15.6%),革兰阴性菌1296株(80.4%),真菌64株(4.0%)。革兰阳性菌以肠球菌属为主(89.2%),革兰阴性菌以大肠埃希菌为主(38.6%)。革兰阳性菌耐药率比较稳定,4年时间无明显变化。革兰阴性菌对大部分抗菌药物的耐药率呈上升趋势,其中肺炎克雷伯菌和铜绿假单胞菌的耐药率上升。结论胆道疾病患者胆汁培养检出率以革兰阴性菌为主,部分病原菌耐药趋势明显,应当加强临床规范用药,预防多重耐药菌的传播与控制。

Objective This study aims to investigate changes in the distribution of infectious bacteria and the trend of drug resistance in patients with biliary tract disease.Methods The positive results of bile cultured in the Microbiology Room of Zhoushan Hospital Laboratory Center from January 2019 to December 2022 were retrospectively analyzed,and the distribution of infectious pathogens and the drug susceptibility test results of patients with biliary diseases were studied.Results From 2019 to 2022,a total of 1611 strains of pathogenic bacteria,251 strains of gram-positive bacteria(15.6%),1296 strains(80.4%)of gram-negative bacteria and 64 strains of fungi(4.0%)were isolated from bile samples.Gram-positive bacteria were mainly Enterococcus(89.2%),and Gram-negative bacteria were mainly Escherichia coli(38.6%).The resistance rate of gram-positive bacteria was relatively stable,with no significant change in four years.The resistance rate of gram-negative bacteria to most antibacterial drugs was on the rise,among which the resistance rate of Klebsiella pneumoniae and Pseudomonas aeruginosa had increased significantly.Conclusion The bile-negative bacteria were mainly detected in patients with biliary tract diseases,and there was no significant change in the composition of bacteria in the past four years.Clinical standard drug use should be strengthened to prevent the spread and control of multi-drug resistant bacteria.