近年急性重症胆管炎胆汁病原学及药敏分析

目的：探讨近年急性重症胆管炎（ACST）主要病原微生物及其对常用抗生素的耐药情况,以指导临床用药,方法：术中抽取ACST胆汁,应用法国生物梅里埃公司细菌自动分析系统分离菌株,。同时进行抗生素药敏测定,结果：24例ACST培养出30株病原策生物,阳性率100％,其中大肠艾希菌9株（30％）,肺炎克雷伯菌8件（26．6％）,铜绿假 菌5株（16．6％）,肠球菌6株（20％）,革兰氏阴性杆菌对复方新诺明耐药率达100％,对庆大霉素,丁胺卡那耐药率分别为58．3％,37．5％,对氨苄青霉素耐药率为79．16％,对阿莫西林／克拉维酸亦达75％,对头孢一代（头孢唑林钠）耐药率29．1％,对头孢三代（头孢噻肟钠,头孢噻吩）亦达29．1％,T 37．5％,6例肠球菌中对青霉素,头孢菌素,万古霉素普遍敏感,结论：急性重症胆管炎主要病原菌是大肠艾希菌,肺炎克雷伯菌,铜绿假单胞菌及肠球菌,治疗宜选用主要针对革兰氏阴性杆菌的敏感抗生素。

PATHOGENIC MICROBES OF ACUTE SEVERE CHOLANGEITIS AND THEIR RESISTANCE TO ANTIBIOTICS IN RE CENT YEARS

Objective To understand the main pathogenic microbes of acute severe cholangeitis(ACST) and their resistance to antibiotics so as to instruct ational application of antibiotics clinically.Method All isolates were identified by analytic products incorporation bio Merieux,and the drug sensitivity test to microbes was done by minimal inhibition concentration (MIC).Result There were 30 pathogenic microbes (24 lines of Gram's negative and 6 lines of Gram's positive) in 24 patients with acute severe cholangeitis.Gram's negative bacterium include Escherichia coli(30%),Klebsiella pneumoniae (26.6%) and Pyocyaneus aeruginosa (16.6%).6 lines of the Gram's positive were intestinal cocci,no pseudomonas aeruginosa and staphylococcus aureus was found.The resistance rate of Gram's negative bacterium to sultamethoxazole,gentamicine,amicacine,ampicillinum amoxycillinum/clavulanic acid,cefazolinum,cefotaxime,cefalotin was 100%,58.3%,37.5%,79.6%,75%,29.1%,29.1% and 37.5% respectively.For the Gram's positive cocci,most of them were sensitive to penicillin,cephalosporin,vancomycin.Conclusion The main pathogenic microbes of ACST were Escherichia coli,Klebsiella pneumoniae,intestinal cocci,The antibiotic sensitive to Gram's bacterium is the first choice.