CAJ | 학술논문

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。
목적：료해담총관결석환자담즙병원균분포특점급기내약정황。방법대72례담총관결석환자적담즙표본행병원균배양급약물민감성시험。결과72례담즙표본공배양균주60주，기중혁란음성균45주（75％），혁란양성균12주（20％），진균3주（5％）；배렬전3위적세균의차위대장애희균（30％）、시장구균（12％）、폐염극뢰백간균폐염아충（10％）。혁란음성균대아알배남、아미잡성민감솔최고（균위95％），대안변청매소적내약솔고체89％；혁란양성균대만고매소、체고랍저、리내서완민감솔최고（균위100％），대청매소G내약솔82％。결론담총관결석환자담즙세균이혁란음성간균위주，치료일반수선고필응용혁란음성균민감솔고적항생소。
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 ) treat-ment.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 commo-nest pathogens in patients with common bile duct stones in this hospital , the application of high rate of gram-negative bacteria sensitive antibiotics should be considered firstly in treatment of such patients .