经皮经肝胆道引流术后感染的临床观察

目的:了解引起经皮经肝胆道引流(PTCD)术后感染致病菌的分布情况,并比较血液细菌培养和胆汁细菌培养在检出致病菌上的差异。方法:对2年来31例梗阻性黄疸患者在PTCD术后感染时分别采集血液和胆汁,并进行细菌培养及药敏测试。结果:31份胆汁中有29份标本培养出细菌,阳性检出率为93.5%;共培养出细菌37株,其中革兰阴性杆菌24株(64.9%),革兰阳性球菌8株(21.6%),真菌5株(13.5%)。革兰阴性杆菌对亚安培南/西司他叮的敏感率最高,为92.3%,其次为头孢哌酮/舒巴坦、头孢吡肟,敏感率分别为84.6%、84.6%。革兰阳性球菌对万古霉素的敏感率为100.0%,丁胺卡那霉素92.3%敏感。结论:胆道感染病原菌以革兰阴性杆菌为主,胆汁细菌培养阳性率显著高于血细菌培养。

Clinical observation of infection after percutaneous transhepatic cholangic drainage

Objective To survey the main pathogenic bacteria community of patients with infection after PTCD(percutaneous transhepatic cholangic drainage). Methods 31 patients with infection after PTCD were studied. Blood and bile samples were collected from each of the 31 patients respectively. Results Positive rate of bacteria culture from blood and bile samples were 93.5% and 35.5% respectively. Totally 37 strains were identified from bile culture including 24 gram negative strains(64.86%) and 8 gram positive strains(21.62%), 5 fungal strains (13.51%). Negative strains were susceptible to Tienam(92.31%), Cefoperazone/Sulbactam(84.62%) and Cefepime(84.62%). All positive strains was susceptible to Vancomycin. Conclusion Gram negative strains were the major pathogenic bacteria. The positive rate of bacterium culture from bile samples was higher than that from blood samples significantly.