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目的观察并分析胆石症患者胆汁中菌群分布及胆汁培养细菌药物敏感谱,以指导临床选择抗生素。方法选择胆石症患者450例,通过术中采集胆囊及胆总管的胆汁进行细菌培养及药敏感验。结果胆汁细菌培养阳性率为26.2%(118/450),其中革兰阴性菌占66.9%(83/124),革兰阳性细菌占29.8%(37/124),前三位分别是大肠埃希氏菌、肺炎克雷伯菌、粪肠球菌,并且有4例真菌感染。结论胆汁中病菌种类较多,主要为革兰阴性杆菌,但革兰阳性球菌呈上升趋势,药物敏感谱亦有明显变化,临床常用抗生素耐药性明显增加,应根据药敏合理选择抗生素。
Objective To observe and analyze the distribution of bile flora in patients with cholelithiasis and the sensitive spectrum of bacterial drug in bile culture to guide the clinical selection of antibiotics. Methods 450 cases of cholelithiasis patients were selected, the gallbladder and common bile duct were collected for bacterial culture and drug susceptibility test. Results The positive rate of bile bacteria culture was 26.2% (118/450), of which Gram-negative bacteria accounted for 66.9% (83/124), Gram-positive bacteria accounted for 29.8% (37/124), the first three were Escherichia coli Klebsiella pneumoniae, Enterococcus faecalis, and 4 cases of fungal infections. Conclusions There are many kinds of bacteria in bile, mainly Gram-negative bacilli, but Gram-positive cocci is on the rise, and the sensitive spectrum of drugs is also obviously changed. The antibiotic resistance of clinical commonly used antibiotics is obviously increased.