胆道感染病原菌调查与耐药性分析

目的：了解胆道感染胆汁中的主要致病菌及其耐药情况，指导临床合理用药，方法：对1999年1月－2000年12月期间我院403例胆道感染胆汁细菌培养阳性的481株致病菌的分布情况及其耐药结果作回顾性分析。结果：481株胆汁培养阳性的病原菌中革兰阴性杆菌371株（77．1％），其中大肠埃希菌114株（23．7％），肺炎克雷伯菌92株（19．1％），革兰阳性球菌103株（21．4％），其中肠球菌71株（14．8％），真菌属7株（1．5％），革兰阴性杆菌对头孢他啶和亚安培南的耐药率为21．1％和8．89％，革兰阳性球菌对亚安培南和万古霉素的耐药率为24．3％和7．77％，结论：胆道感染主要病原菌是大肠埃希菌，肺炎克雷伯功和肠球菌。头孢他啶和亚安培南可作为治疗胆道感染的首选用药。

Clinical Research on Pathogenic Bacteria of Biliary Infection and Their Resistance to Antibiotics

Objective: The aim of this study was to analyse the pathogenic bacteria of biliary infection and their resistance to antibiotics. Methods: Between January 1999 and December 2000, 481 pathogenic bacteria of biliary infection(403 patients) and their resisitance to antibiotics were studied retrospectively. Results: In regard to 481 pathogenic bacteria with positive biliary culture, 371(77.1%) were gram-negative bacilli, of which 114(23.7%) were Escherichia coli,92(19.1%) were Klebsiella pneumoniae.103(21.4%) were gram-positive cocci, of which 71(14.8%) were intestinal cocci. 7(1.5%) were fungi. Gram-negative bacilli was sensitive to ceftazidine and imipenem with low resistance rate of 21.1% and 8.89%.Gram-positive cocci was sensitive to imipenem and vancomycin with resistance of 24.3% and 7.77%. Conclusion: 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 biliary infection.