摘要
目的了解医院近6年来胆道感染的病原菌分布及变迁,为临床经验性治疗用药提供依据。方法对2001年1-2006年12月间收治的371例胆道感染患者的胆汁细菌培养阳性的359株病原菌分布及耐药情况作回顾性分析。结果2001-2003年、2004-2006年2个时间段140、231份胆汁标本中各有84、188份病原菌培养阳性,分别检出病原菌105、254株;所分离的病原菌以革兰阴性杆菌为主,2个时间段分别占60.0%、50.8%,革兰阳性菌分别占34.3%、40.2%,真菌分别占5.7%、9.0%;大肠埃希菌仍占最大比例,2个时间段分别为36.2%、31.1%,其超广谱β-内酰胺酶(ESBLs)阳性率显著增加(34.2%、60.8%,P<0.05)。结论胆道感染的病原菌中主要以大肠埃希菌、肠球菌属等为主,2001-2003年、2004-2006年2个时间段相比较,大肠埃希菌中ESBLs阳性耐药株、铜绿假单胞菌、嗜麦芽寡养单胞菌和真菌明显增多;引起胆道感染的病原菌发生明显的变迁,对药物耐药性普遍增高,胆道手术需加强病原菌的检测和耐药性分析,合理进行预防性用药,有效控制胆道感染的发生。
OBJECTIVE To find out the changes of pathogens and their sensitivity to antibiotics in bile samples of patients with biliary tract infection of our hospital during last six years. METHODS The data of 359 strains of microbes found in 371 patients with positive bile culture from Jan 2001 to Dec 2006 and their sensitivity to antibiotics were statistically analyzed. RESULTS There were 84 and 188 positive samples respectively in 140 samples during the first half of this study （2001-2003）and 231 ones during the second half （2004-2006） as well as 105 and 254 strains cultured. Respectively, Gram-negative bacteria accounted for 60.0%, and 50. 8% and Gram-positive cocci 34.3%, and 40. 2% and fungi 5.7%, and 9.0% ; Escherichia coli was the major one and accounted for 36.2%, and 31. 1%, with the increasing incidence of the positive rates of its ESBLs.（34.2% vs 60.8%, P〈0. 05） in the above-mentioned two stages. CONCLUSIONS The main pathogens of biliary infection are E. coli and Enterococcus. The prevalences of E. coli positive strains of ESBLs, Pseudomonas aeruginosa and fungi greatly increased during the second half of this study （2004- 2006）. Varieties of pathogens of biliary tract infection have evidently changed as well as their antibiotic resistance is increasing. It is important to keep on detecting the changes of biliary pathogens and their sensitivity to antibiotics and using them properly for prevention so as to control the biliary tract infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第3期440-442,共3页
Chinese Journal of Nosocomiology
