胆道感染的致病菌变迁和耐药趋势

目的 :研究胆道感染的致病菌分布、变迁和耐药趋势。方法 :对本院 1990年 1月— 1999年 12月住院的 733例胆道感染病人胆汁标本进行细菌培养、鉴定和药敏试验。回顾性分析了培养阳性的 795株需氧菌及其药敏试验结果。结果 :胆道感染的病原菌中 ,大肠埃希菌为主的革兰阴性菌占 83.9% ,葡萄球菌、肠球菌为主的革兰阳性菌占 15 .0 % ;厌氧菌占 32 .5 % ,复数菌感染占 10 .2 %。大肠埃希菌 315株 ,占首位 ,葡萄球菌属 5 9株 ,甲氧西林耐药的金黄色葡萄球菌 (MRSA)及凝固酶阴性葡萄球菌呈上升趋势 ,且种类多样。克雷伯菌属、嗜麦芽窄食单胞菌、聚团肠杆菌、肠球菌等渐见增多 ,大肠埃希菌、产气肠杆菌比例下降。大肠埃希菌等革兰阴性菌 30 %以上对第三代头孢菌素类耐药 ,5 0 %以上对庆大霉素、环丙沙星耐药。出现耐万古霉素肠球菌。结论 :胆道感染菌种在增加 ,菌群在变迁 ,对临床常用的抗菌药物耐药率增加。

Study of pathogen distribution and trend of antimicrobial resistance in biliary tract infections

Objective: To survey the distribution, trend o f bacteria resistance in biliary tract infections. methods: We analyze d the distribution and bacterial resistance profile of 795 strains of bacterial isolates from 733 inpatients with biliary tract infection from January 1990 to December 1999 retrospectively. Results: Among 795 strains, 83.9% were Gram negative bacteria, 15.0% were Gram positive c occi; 32.5% were anaerobes and 10.2% were multiple-bacteria. E. coli (315 strai ns) were the most common pathogen, the number of MRSA and coagulase negative st aphylococci strains are increasing. S. maltophilia , Klebsiella species and E. agglomerans emerged and the propotion of E. coli and E. aerogenes were decreasing. 38.8% of Gram negative bacteria including E. coli strain s were resistant to third-generation cephalosporins, more than 50% of these strains resistant to gentamicin and ciprofloxacin. Severa l strains of VRE appeared. Conclusion: Types of pathogens of biliary tract infection as well as their antibiotic resistance are increasing.