胆道感染患者胆汁中病原菌的分布及其耐药性分析

目的研究胆道感染患者胆汁中病原性细菌的分布及其耐药性、对抗生素敏感性，为临床抗生素的选择提供参考。方法选择2004年1月。2012年12月在浙江省杭州市萧山区第三人民医院住院患者作为研究对象，对有胆道感染的胆汁标本进行检验．分离、培养并鉴定其病原菌，使用K—B纸片法检测病原菌对药物的敏感性。结果胆道感染患者胆汁中病原性细菌有真菌77株（18．08％）、革兰阳性菌57株（13．38％）、革兰阴性菌292株（68．54％）。其中革兰阴性菌为主要致病菌，包括：铜绿假单胞菌64株（21．91％），大肠埃希菌96株（32．88％），白色念珠菌58株（19．86％），肺炎克雷伯菌45株（15．41％），屎肠球菌29株（9．93％）等。药敏结果显示，革兰阴性菌对美罗培南耐药率最低。结论胆道感染患者大多以革兰阴性杆菌感染为主，其中真菌的检出率较高、多重耐药株所占比例较高，并且有上升的趋势，因此临床中应根据药敏实验的结果选择合适的抗生素。

Distribution of pathogens in bile of pathents with biliary tract infection and analysis on its drug resistance

Objective To study the distribution, drug resistance and antibiotics sensitivity of pathogenic bacteria in bile of pa- tients with biliary tract infection, and provide clinical reference for antibiotic selection. Methods Patients from January 2004 to December 2012 in the Third People＇s Hospital of Xiaoshan District in Zbejiang Province were selected as study objects, the bile samples with biliary tract infection were tested, and its pathogens were separated, cultured, and identified, the pathogen drug sensitivity were tested by K-B Paper plate method. Results fungus in bile of patients with biliary tract infection was 77 （18.08%）, gram-positive bacteria was 57 （13.38%）, gram-negative bacteria was 292 （68.54%）, and the gram-negative bacteria was the main pathogens including pseudomonas aeruginosa was 64 （21.91%）, escherichia coli was 96 （32.88%）, candida albicans was 58 （19.86%）, klebsiella pneumoniae job strain was 45 （15.41%）, feces enterococcus was 29 （9.93%） and so on. susceptibility results showed that gram-negative bacteria resistant to meropenem lowest rate. Conclusion Most patients with biliary tract infection are gram-negative bacilli infections, the fungi has a higher detection rate, most of them are multi-drug resistant strains, and there is an upward trend, so appropriate selection of antibiotics in the clinical should be based on the results of medicine sensitive experiment.