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目的研究肝外阻塞性黄疸患者胆汁病原菌分布及其耐药性的变化,为临床合理用药提供参考。方法采用细菌分离鉴定技术和药敏试验方法,对某医院235例肝外阻塞性黄疸住院患者胆汁标本进行了病原学检测。结果235例患者送检胆汁标本中,有201例检出病原菌,检出率为85.53%,共培养出病原菌243株。在检出的病原菌中,革兰阴性菌占71.20%,革兰阳性菌占25.51%,真菌占3.29%。革兰阴性菌对亚胺培南、美罗培南、厄他培南等抗菌药物比较敏感,对多数抗菌药物不同程度耐药;革兰阳性菌对万古霉素、替考拉宁、利奈唑胺耐药率较低。结论肝外阻塞性黄疸患者胆道系统多数存在感染,病原菌检出率较高,各种病原菌对抗菌药物均有不同程度的耐药。
Objective To study the distribution of bile pathogens in patients with extrahepatic obstructive jaundice and the change of their drug resistance, so as to provide a reference for clinical rational drug use. Methods Bacterial isolation and identification techniques and susceptibility testing methods were used to detect the etiology of biliary samples from 235 hospitalized patients with extrahepatic obstructive jaundice in a hospital. Results Totally 235 pathogenic bacteria were detected in 201 bile samples from 235 patients, the detection rate was 85.53%. 243 strains were co-cultured. Among the pathogenic bacteria detected, Gram-negative bacteria accounted for 71.20%, Gram-positive bacteria accounted for 25.51%, and fungi accounted for 3.29%. Gram-negative bacteria sensitive to imipenem, meropenem, ertapenem and other antibiotics more sensitive to most of the antimicrobial resistance to varying degrees; Gram-positive bacteria vancomycin, teicoplanin, linezolid resistance Lower drug rates. Conclusion Most of patients with extrahepatic obstructive jaundice have infection in the biliary system, and the detection rate of pathogenic bacteria is high. All kinds of pathogens have different degrees of resistance to antibacterial drugs.