胆道感染细菌学检验与耐药性分析

目的 了解胆道感染病原菌的种类及其对抗菌药物的耐药性,以指导临床用药.方法 调查医院2009年9月-2011年9月收治的170例胆道感染患者,所有患者均通过抽取病变胆囊内胆汁4～6 ml进行细菌培养以及药敏试验.结果 170例患者共培养出病原菌120株,检出率为70.6％；其中革兰阳性菌42株占35.0％；革兰阴性菌78株占65.0％；革兰阳性菌对青霉素类和喹喏酮类敏感率均＞80.0％,对万古霉素敏感率为100.0％；革兰阴性菌对亚胺培南的敏感率为100.0％.结论 胆道感染病原菌以革兰阴性菌为主,普通感染可选用喹喏酮类或氨基糖苷类抗菌药物,中、重度感染可选用头孢哌酮/舒巴坦或哌拉西林/他唑巴坦,严重感染可选用亚胺培南.

Bacteriological examination and drug resistance analysis of biliary tract infection

OBJECTIVE To understand the pathogens distribution in the biliary tract infections and their resistance to commonly used antibiotics,and provide reference for clinical practice.METHODS A total of 170 cases of patients with biliary tract infections from Sep 2009 to Sep 2011 in our hospital were analyzed,4-6 ml bile extraction were collected from each patient by intraoperative gallbladder for bacteria culture and drug susceptibility tests.RESULTS A total of 120 strains of pathogens were isolated from 170 patients with the detection rate of 70.6%.There were 42 strains of gram-positive bacteria,accounted for 35.0%;and the rest 78 strains were gram-negative which accounting for 65.0%.G+ bacteria had more sensitive to penicillin and quinolone(80% susceptibility rate of or more),and vancomycin was the most susceptible antibiotics(100% susceptible).Imipenem was the most susceptible antibiotics to the G-bacteria(100% susceptible).CONCLUSION Gram-negative bacteria were the predominnt pathogens of biliary tract infection.We can choose the antibiotics such as the quinolone or the aminoglycosides for normal infections,choose cefoperazone/sulbactam or piperacillin/tazobactam for moderate or severe infection,and choose imipenem for serious infection.