【摘要】 目的了解2007年11月-2010年11月143例胆道手术患者医院感染病原菌的分布及其耐药性,为临床合理选择抗菌药物及治疗提供依据。方法对143例进行胆道手术患者的胆汁标本进行病原菌培养、鉴定及药敏分析。结果 143份标本中有85份检出病原菌,阳性率59.40%,其中7例为混合感染;共检出病原菌92株,革兰阳性菌49株占53.26%,革兰阴性菌43株占46.74%,革兰阳性菌前3位为屎肠球菌、表皮葡萄球菌、金黄色葡萄球菌,分别占20.65%、16.30%、10.87%,革兰阴性菌前3位为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,分别占19.57%、13.04%、10.87%;铜绿假单胞菌耐药性最严重,肠杆菌科细菌产超广谱β-内酰胺酶(ESBLs)检出率>50.00%;革兰阳性球菌中肠球菌属对青霉素及红霉素耐药率达57.89%、84.21%,表皮葡萄球菌耐药性普遍高于金黄色葡萄球菌。结论胆道手术后患者胆道感染的病原菌分布存在变化,耐药性严重,监测手术后患者胆道感染病原菌的耐药性及变化规律对指导临床抗菌药物合理应用有重要作用。更多还原

【Abstract】 OBJECTIVE To investigate the pathogens causing nosocomial infections in the patients undergoing biliary tract surgery from Nov 2007 to Nov 2010 and drug resistance so as to provide basis for the reasonable clinical medication and treatment.METHODS The bile specimens obtained from 143 patients undergoing biliary tract surgery were performed for the bacterial culture,identification and drug susceptibility testing.RESULTS The pathogens were isolated from 85 of 143 specimens with the positive rate of 59.40%,7 cases were with mixed infections;a total of 92 strains of pathogenic bacteria were isolated,including 49 strains of gram-positive bacteria(53.26%) and 43 strains of gram-negative bacteria(46.74%);the top three gram-positive bacteria were Enterococcus faecium(20.65%),Staphylococcus epidermidis(16.30%),and S.aureus(10.87%);the top three gram-negative bacteria were Escherichia coli(19.57%),Klebsiella pneumoniae(13.04%),and Pseudomonas aeruginosa(10.87%);the drug resistance of P.aeruginosa was the most serious;the detection rate of ESBL-producing Enterobacteriaceae was higher than 50.00%;the drug resistance rates of Enterococci to penicillin and erythromycin were 57.89% and 84.21%,respectively,the resistant rate of S.epidermidis was generally higher than that of S.aureus.CONCLUSION The distribution of bacteria isolated from bilie in patients with biliary tract infections after surgery is in change,and the drug resistance is serious;it is of great significance in the reasonable use of antibiotics to monitor the change of drug resistance of the pathogens causing biliary tract infections.更多还原