胆道感染病原菌种类及药物敏感性分析

目的:了解胆道感染病原菌的种类和对常用抗生素的敏感性情况。方法:取605例胆道感染病人胆汁标本进行培养,对分离出的病原菌进行鉴定和药物敏感试验。结果:424例病人胆汁培养阳性(70.1%),共分离细菌580株。4种主要革兰阴性杆菌对青霉素类、头孢菌素类和喹诺酮类抗生素的耐药率均超过30%,对哌拉西林/他唑巴坦、亚胺培南和阿米卡星的耐药率低于20%。肠球菌属对青霉素、氨苄西林、红霉素、四环素的耐药率超过25%,对氨基糖苷类、喹诺酮类和万古霉素相对敏感。结论:针对中、重度胆道感染的经验性治疗推荐哌拉西林/他唑巴坦、亚胺培南或阿米卡星加喹诺酮类或万古霉素加甲硝唑的联合用药。

Analysis of species and antibiotic sensitivity of pathogenic bacteria causing biliary tract infection

Objective:To study the types and antibiotic sensitivity of pathogenic bacteria causing biliary tract infection.Methods: Six hundred and five bile specimens were cultured and bacteria were isolated.Drug sensitivity were performed and analyzed.Results: Among 605 specimens,424 cases were cultured positive(70.1%) and 580 isolates were collected.The resistance rate of the main four types of Gram-negative bacillus to penicillins,cephalosporin and quinolones all exceeded 30%.Whereas the resistance rate to piperacillin / tazobactam,imipenem and amikacin were less than 20%.Enterococcus were more resistant to penicillin,ampicillin,erythromycin and tetracycline(>25%) than to aminoglycoside,quinolones and vancomycin.Conclusion: The following drug scheme was recommended in biliary tract infection,which was the joint use of piperacillin / tazobactam,imipenem and amikacin,plus quniolones or vancomycin and metronidazole.