胆道术中胆汁细菌培养及药敏试验

Bile bacterial culture and application of antibiotics in biliary surgery

目的 探讨胆道外科感染的常见病原微生物及其对 1 4种抗生素的敏感情况 ,为临床用药提供参考。方法 对近 3年来胆道手术中获取的胆汁标本进行培养和药敏实验。结果 32 5例胆汁标本培养以革兰氏阴性菌为主 (占 84 .3% ) ,其中大肠艾希氏菌 4 7例 (占 2 0 .4 % ) ,肠杆菌属 38例(占 1 6 .5 % )最多见。对革兰氏阴性菌较为敏感的有丁胺卡那霉素、万古霉素、环丙沙星。菌必治和复达欣对革兰氏阳性、阴性菌均敏感。结论 胆道外科感染主要选用针对革兰氏阴性杆菌和厌氧菌的抗生素 ,严重感染时须用广谱抗生素 。

Objective To explore the common pathogens of biliary infection and their sensitivity to 14 antibiotics.Methods The bile obtained from biliary tract surgery in resent 3 years was cultured and tested for antibiotics sensitivity.Results Gram negative bacilli was dominant in 325 cases of bile samples ( 84.3% ). Escherichia Coli accounting for 20.4% and intestinal bacilli for 16.5% were most common. Sensitive antibiotics to Gram negative bacteria were amikacin, circlesacin, vancomycin. Ceftriaxone and ceftazidime were sensitive abtibiotics to Gram negative and positive bacteria.Conclusion we should select antibiotics against Gram negative bacteria and anaerobic bactibilia in general biliary infection. In severe infection, broad spectrum antibiotics should be used in combination with surgical drainage.