摘要
目的分析胆石症合并胆道感染(CBI)患者胆汁中的病原菌分布、构成及耐药情况,为临床合理用药提供参考。方法选取行胆道手术的CBI患者180例,采集胆汁标本,进行细菌种类鉴定和药敏试验。结果共分离到病原菌132株,其中革兰阴性菌98株(74.24%)、革兰阳性菌31株(23.49%)、真菌3株(2.27%)。最常见的病原菌依次为大肠埃希菌51株(38.64%),肠球菌属23株(17.43%),肺炎克雷伯菌22株(16.67%),阴沟肠杆菌14株(10.60%),铜绿假单胞菌和葡萄球菌属各7株(5.30%)。检出的革兰阴性菌仅对亚胺培南耐药率为0.00%,其中大肠埃希菌和肺炎克雷伯菌对头孢哌酮/舒巴坦、阿米卡星的耐药率较低,而阴沟肠杆菌对阿米卡星的耐药率也较低;革兰阳性菌对万古霉素、利奈唑胺高度敏感,对庆大霉素的耐药率较低,其中葡萄球菌属对左氧氟沙星亦未发现耐药菌株。结论 CBI患者胆汁中的病原菌对大多数常用抗菌药物均产生了不同程度的耐药性,临床应根据药敏试验结果合理选用抗菌药物。
Objective To investigate the pathogens distribution and antibiotic resistance in patients with cholelithiasis complicated with biliary infection（CBI）,so as to provide some guidance for reasonable clinical use of antibiotics.Methods A total of 180 patients with CBI were enrolled in the study.The bile samples were collected from these patients during the operations.Then the isolation and identification of pathogens and antibiotics susceptibility were tested.Results A total of 132 bacterial strains were isolated,including 98 strains of gram-negative bacteria（74.24%）,31 strains of gram-positive bacteria（23.49%） and three fungal strains（2.27%）.The top six kinds of strains were as following：Escherichia coli,51 strains（38.64%）;Enterococcus,23 strains（17.43%）;Klebsiella pneumonia,22 strains（16.67%）;Enterobacter cloacae,14 strains（10.60%）;Pseudomonas aeruginosa,7 strains（5.30%） and Staphylococcus had 7 strains（5.30%）,respectively.None of the main Gram-negative strains resisted to imipenem.Escherichia coli and Klebsiella pneumonia strains showed a lower resistance to cefoperazone/sulbactam and amikacin while Enterobacter cloacae showed a lower resistance to amikacin.The main gram-positive strains showed a high susceptibility to vancomycin and linezolid,and a lower resistance to gentamycin.Besides,none of Staphylococcus strains resisted to levofloxacin.Conclusion The pathogens in CBI patients are generally resistant to the commonly used antibiotics.Antibiotics should be used reasonably basing on the results of the drug susceptibility testing.
出处
《检验医学与临床》
CAS
2017年第10期1451-1452,1455,共3页
Laboratory Medicine and Clinic
关键词
胆石症
胆道感染
病原菌
抗菌药物
耐药性
cholelithiasis
biliary infection
pathogen
antibiotic drug
resistence
