【摘要】 目的了解胆总管结石患者胆汁病原菌分布特点及其耐药情况。方法对72例胆总管结石患者的胆汁标本行病原菌培养及药物敏感性试验。结果 72例胆汁标本共培养菌株60株,其中革兰阴性菌45株(75%),革兰阳性菌12株(20%),真菌3株(5%);排列前3位的细菌依次为大肠埃希菌(30%)、屎肠球菌(12%)、肺炎克雷伯杆菌肺炎亚种(10%)。革兰阴性菌对亚胺培南、阿米卡星敏感率最高(均为95%),对氨苄青霉素的耐药率高达89%;革兰阳性菌对万古霉素、替考拉宁、利奈唑烷敏感率最高(均为100%),对青霉素G耐药率82%。结论胆总管结石患者胆汁细菌以革兰阴性杆菌为主,治疗一般首先考虑应用革兰阴性菌敏感率高的抗生素。更多还原

【Abstract】 Objective To analysis the distribution of bile pathogenic bacteria and the change of drug sensitivity in patients with CBDS,and to guide rational antibiotics application.Methods Bile specimens of 72 patients with CBDS were collected through endoscopic retrograde pancreatic angiography(ERCP) treatment.Pathogenic bacteria cultivation and drug sensitivity test were applied.Results Sixty strains were trained,including gram-negative bacterium 45 strains(75%),gram-positive 12 strains(20%),fungi 3 strains(5%).The top three predominant pathogenic bacteria were escherichia coli(30%),entercoccus faecium(12%),klebsiella pneumoniae(10%).Drug sensitivity showed highest sensitive rate(95%) of gram-negative strains to imipenem,amikacin.The resistant rate of gram-negative strains to ampicillin was up to 89%.The sensitive rate of gram-positive strains to vancomycin,teicoplanin linezolid was the highest(100%).The resistant rate of gram-positive strains to penicillin G was 82%.Conclusions Gram-negative strains remained the commonest pathogens in patients with common bile duct stones in this hospital,the application of high rate of gramnegative bacteria sensitive antibiotics should be considered firstly in treatment of such patients.更多还原