论文部分内容阅读
目的：了解胆道感染患者胆汁中病原菌的分布特点及其对抗菌药物的敏感性变化，为临床合理用药提供依据。方法回顾性分析医院2009年1月－2013年12月诊断为胆道感染、胆结石患者的胆汁细菌培养阳性结果。结果218份胆汁标本病原菌培养阳性137例，阳性率为62．84％；分离培养病原菌167株，其中革兰阴性菌88株占52．69％、革兰阳性菌65株占38．92％、真菌14株占8．39％，革兰阴性杆菌对亚胺培南、哌拉西林／他唑巴坦、妥布霉素、呋喃妥因、头孢西丁耐药率较低，分别为2．27％、17．05％、27．27％、36．36％，革兰阳性菌对万古霉素、利奈唑胺、呋喃妥因、莫西沙星的耐药率较低。结论胆汁中病原菌以大肠埃希菌、肺炎克雷伯菌为主，肠球菌属、真菌的比例也较高，临床应加强病原菌检测，依据药敏结果合理选择抗菌药物。“,”OBJECTIVE To understand the distribution and drug susceptibility of pathogens isolated from bile speci‐mens of the patients with biliary tract infections so as to provide guidance for reasonable clinical use of antibiotics . METHODS The patients who were diagnosed as biliary tract infections ,gallstones from Jan 2009 to Dec 2013 were enrolled in the study ,then the results of positive culture of bile specimens were retrospectively analyzed .RESULTS Of 218 bile specimens ,137 were cultured positive for pathogens ,with the positive rate of 62 .84% .A total of 167 strains of pathogens have been isolated ,including 88 (52 .69% ) strains of gram‐negative bacteria ,65 (38 .92% ) strains of gram‐positive bacteria ,and 14 (8 .39% ) strains of fungi .The drug resistance rates of the gram‐negative bacilli to imipenem ,piperacillin‐tazobactam ,tobramycin ,nitrofurantoin ,and cefoxitin were 2 .27% ,17 .05% , 27 .27% ,and 36 .36% ,respectively .The drug resistance rates of the gram‐positive bacteria to vancomycin ,lin‐ezolid ,nitrofurantoin ,and moxifloxacin were low .CONCLUSION Escherichia coli and K lebsiella pneumoniae are dominant among the pathogens isolated from the bile specimens ,and Enterococci and fungi also occupy high pro‐portions .It is necessary for the hospital to strengthen the detection of pathogens and reasonably use antibiotics based on the results of drug susceptibility testing .