化脓性胆管炎胆汗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78.8％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％。结论化脓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茼药物的使用时间和剂量。

CLINICAL RESEARCH ON PATHOGENIC BACTERIA OFPURULENT CHOLANGITIS AND THEIR SENSIITIVTY 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 retrospectivdy. Results: In regard to 670 pathogenic bacteria with positive biliary culture, 509 (75.9%) were gram-negative bacilli,of which 155 (23.1%) were Eschenchia 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 pathogernic 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.