T管胆汁细菌培养及对抗生素敏感性分析

目的：了解临床已无感染症状病人的T管引流胆汁的细菌感染情况及对抗生素的敏感性。方法：对2001年12月至2002年12月116例术后已无感染症状病人的T管引流胆汁的细菌培养和抗生素敏感性试验结果作统计分析。结果：T管胆汁细菌培养的阳性率为59．91％。158株微生物中包括23种细菌和3种真菌。肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、表皮葡萄球菌、金黄色葡萄球菌、粪肠球菌和尿肠球菌占胆道细菌的72．75％，24例混合感染中13例感染铜绿假单胞菌，同时发现嗜麦芽窄食单胞菌和鲍曼不动杆菌等条件致病菌感染。细菌对头孢类抗生素具有较高的耐药率，对亚胺培南、万古霉素、阿米卡星有较高的敏感性。在不同病人相同菌种的药敏试验结果有较大差异，提示菌株不同。结论：临床无感染症状病人的T管引流胆汁具有较高的细菌感染率，二重感染和耐药菌株的增加是一旦发生胆汁性腹膜炎时严重感染的基础。

T-tube Bile Bacteria Culture and Their Sensitivity to Antibiotics

Objective:To study the T tube bile bacterial harbouring status and bacteria sensitivity to antibiotics in patients without clinical manifestation of infection.Methods:The data of T-tube of bacterial culture were studied in116patients without clinical manifestation of infection(admitted from Dec2001to Dec2002)and their sensitivity to antibiotics were statisticlly analyzed.Results:The positive rate of bacterial culture was59.91%.There were158strains of microbes belonging to26species,including23bacterial and3fungal.Klebsiella pneumoniae,Peudomonas aeruginosa,E.coli,Staphylococcis(epidermidis and aureus)and Enterococci(faecalis and faecium)constituted72.75%of the biliary bacteria.Among24cases of mixed infection,13were infected with Peudomonas aeruginosa.The conditional infections including Stenotrophomonia maltophilia and Acinetobacter baumannii were also found.The bacteria were highly resistant to cephalosporins.However,they were highly sensitive to imipenem,vancomycin and amikacine.The same bacteria cultured from different patients showed different patterns of antibiotics sensitivity,which indicated existence of different strains.Conclusions:The T tube bile of patients without clinical manifestation of infection had much higher incidence of bacterial infection than expected.Secondary infection and resistance to antibiotics are increased in incidence which explains the occurrence severe infection when biliary peritonitis occurs.