本文選題：膽總管結(jié)石 + 膽道感染��； 參考：《中華醫(yī)院感染學(xué)雜志》2015年17期

【摘要】：目的對膽總管結(jié)石伴膽道感染患者進(jìn)行膽汁培養(yǎng),對其病原菌分布及耐藥性進(jìn)行統(tǒng)計分析,為臨床用藥提供指導(dǎo)。方法選取醫(yī)院2012年1月-2013年2月120例膽總管結(jié)石患者為研究對象,所有患者行內(nèi)鏡逆行胰膽管造影術(shù)(ERCP),術(shù)中抽取膽汁標(biāo)本,進(jìn)行細(xì)菌培養(yǎng)及藥敏分析。結(jié)果 120例膽總管結(jié)石患者中96例檢出病原菌,檢出率為80.0%;共分離出病原菌107株,其中革蘭陰性菌共檢出75株占70.1%,革蘭陽性菌30株占28.0%,真菌2株占1.9%;大腸埃希菌對亞胺培南、美羅培南及環(huán)丙沙星較敏感,耐藥率20.0%,肺炎克雷伯菌和銅綠假單胞菌對亞胺培南、美羅培南高度敏感,耐藥率均為0;糞腸球菌對萬古霉素、磷霉素及氯霉素較為敏感,耐藥率10.0%;真菌對酮康唑、伊曲康唑、制霉菌素及兩性霉素較敏感。結(jié)論引起膽總管結(jié)石患者膽道感染的病原菌主要以革蘭陰性菌為主,病原菌對常用抗菌藥物表現(xiàn)出一定的耐藥性,臨床應(yīng)根據(jù)藥敏試驗結(jié)果合理選用抗菌藥物,避免盲目用藥。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and drug resistance in bile culture of patients with choledocholithiasis and biliary tract infection in order to provide guidance for clinical use of drugs. Methods 120 patients with choledocholithiasis from January 2012 to February 2013 were studied. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Results among 120 patients with choledocholithiasis, 96 cases (80.0%) were found to have pathogenic bacteria, 107 strains were isolated, 75 strains were Gram-negative bacteria, 30 strains were Gram-positive bacteria, 28.0 strains were Gram-positive bacteria, and 2 strains were fungi. Mepenem and ciprofloxacin were sensitive, the drug resistance rate was 20.0. Klebsiella pneumoniae and Pseudomonas aeruginosa were highly sensitive to imipenem and meropenem, and the resistance rate was 0. Enterococcus faecalis was sensitive to vancomycin, fosfomycin and chloramphenicol. The resistance rate was 10.0. The fungi were sensitive to ketoconazole, itraconazole, nystatin and amphotericin. Conclusion Gram-negative bacteria are the main pathogens causing choledocholithiasis, and the pathogens are resistant to common antimicrobial agents. According to the results of antimicrobial susceptibility test, antimicrobial agents should be selected rationally in clinic to avoid blind use of antibiotics.
【作者單位】： 瑞安市人民醫(yī)院消化內(nèi)科;
【基金】：浙江省醫(yī)藥衛(wèi)生計劃基金資助項目(2011KYA011)
【分類號】：R575.62;R446.5

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本文編號：2063973