化脓性胆管炎胆汁致病菌与药物敏感的临床研究

目的：了解化脓性胆管炎胆汁中的主要致病菌及药物敏感情况，指导临床合理用药，方法：对593例化脓性胆管炎胆汁细胞培养阳性的670株致病菌的分布情况及其药物敏感结果作回顾性分析，结果：670株胆汁培养阳性的病原菌中革兰氏阴性杆菌509株（75．9％），革兰氏阳性球菌149株（22．2％），革兰氏阴性杆菌对头孢他啶和亚安培南的敏感率为76．8％和90．6％，革兰氏阳性球菌对亚安培南和万古霉素的敏感率达77．2％和91．3％，结论：化 性胆管炎主要病原菌是大肠埃希菌，。肺炎克雷伯菌和肠球菌，头孢他啶和亚安培南可作为治疗化脓性胆管炎的首选用药，及早内镜下鼻胆管引流可以减少抗菌药物的使用时间和剂量。

CLINICAL RESEARCH ON PATHOGENIC BACTERIA OF PURULENT CHOLANGITIS AND THEIR SENSITIVITY TO ANTIBIOTICS

Objective:The aim of this study was to analyse the pathogenic bacteria of purulent cholangitis and their sensitivity to antibiotics.Methods:Between January 1998 and December 2000,670 pathogenic bacteria of purulent cholangitis (593 patients) and their sensitivity to antibiotics were studied retrospectively.Results:In regard to 670 pathogenic bacteria with positive biliary culture,509 (75.9%) were gram-negative bacilli,of which 155 (23.1%) were Escherichia coli,126(18.8%) were klebsiella pneumoniae.149(22.2%) were gram-positive cocci,of wihch 101(15.1%) were intestinal cocci.12(1.79%) were fungi.Gram-negative bacilli was sensitive to ceftazidine and imipenem with sensitivity of 78.8% and 90.6%,Gram-positive cocci was sensitive to imipenem and vancomycin with sensitivity of 77.2% and 91.3%. Conclusions:The main pathogenic bacteria of purulent cholangitis were Escherichia coli,Klebsiella pneumoniae and intestinal cocci.Ceftazidine and/or imipenem may be the first medicine to treat purulent cholangitis.Earlier endoscopic nose-blie drainage can reduce antibiotics' use time and dosage.