临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2014年
11期
1153-1156
,共4页
胆管炎%胆汁%细菌感染%微生物敏感性试验
膽管炎%膽汁%細菌感染%微生物敏感性試驗
담관염%담즙%세균감염%미생물민감성시험
colangitis%bile%bacterial infections%microbial sensitivity tests
目的：调查不同程度急性胆管炎患者的胆汁细菌培养及药敏状况，为临床合理用药及预防提供数据指导。方法对2010年4月－2014年4月收治的230例急性胆管炎患者的资料进行回顾性分析，采用VITEK2 Compact微生物仪对患者胆汁进行细菌种类鉴定及药物敏感性试验。计量资料组间比较采用方差分析，计数资料采用χ2检验。结果230例患者中172例患者胆汁培养存在细菌，阳性率为74．78％（172/230）；共检出病原菌237株，其中革兰氏阳性菌135株，占56．96％，以肠球菌属、金黄色葡萄球菌为主；革兰氏阴性菌96株，占40．51％，以铜绿假单胞菌、大肠杆菌、肺炎杆菌为主；真菌6株，占2．53％，以酵母菌为主。轻度胆管炎与重度胆管炎细菌感染率比较差异具统计学意义（χ2＝4．58，P＝0．028）。革兰氏阴性菌是轻、中度急性胆管炎的主要细菌类别，多重细菌感染是重度急性胆管炎细菌感染的主要形式。细菌对万古霉素、亚胺培南和阿米卡星等的敏感率较高。结论革兰氏阳性菌是急性胆管炎的主要病原菌，应早期介入治疗，及时病原菌检测及药敏试验，为临床治疗提供准确方向。
目的：調查不同程度急性膽管炎患者的膽汁細菌培養及藥敏狀況，為臨床閤理用藥及預防提供數據指導。方法對2010年4月－2014年4月收治的230例急性膽管炎患者的資料進行迴顧性分析，採用VITEK2 Compact微生物儀對患者膽汁進行細菌種類鑒定及藥物敏感性試驗。計量資料組間比較採用方差分析，計數資料採用χ2檢驗。結果230例患者中172例患者膽汁培養存在細菌，暘性率為74．78％（172/230）；共檢齣病原菌237株，其中革蘭氏暘性菌135株，佔56．96％，以腸毬菌屬、金黃色葡萄毬菌為主；革蘭氏陰性菌96株，佔40．51％，以銅綠假單胞菌、大腸桿菌、肺炎桿菌為主；真菌6株，佔2．53％，以酵母菌為主。輕度膽管炎與重度膽管炎細菌感染率比較差異具統計學意義（χ2＝4．58，P＝0．028）。革蘭氏陰性菌是輕、中度急性膽管炎的主要細菌類彆，多重細菌感染是重度急性膽管炎細菌感染的主要形式。細菌對萬古黴素、亞胺培南和阿米卡星等的敏感率較高。結論革蘭氏暘性菌是急性膽管炎的主要病原菌，應早期介入治療，及時病原菌檢測及藥敏試驗，為臨床治療提供準確方嚮。
목적：조사불동정도급성담관염환자적담즙세균배양급약민상황，위림상합리용약급예방제공수거지도。방법대2010년4월－2014년4월수치적230례급성담관염환자적자료진행회고성분석，채용VITEK2 Compact미생물의대환자담즙진행세균충류감정급약물민감성시험。계량자료조간비교채용방차분석，계수자료채용χ2검험。결과230례환자중172례환자담즙배양존재세균，양성솔위74．78％（172/230）；공검출병원균237주，기중혁란씨양성균135주，점56．96％，이장구균속、금황색포도구균위주；혁란씨음성균96주，점40．51％，이동록가단포균、대장간균、폐염간균위주；진균6주，점2．53％，이효모균위주。경도담관염여중도담관염세균감염솔비교차이구통계학의의（χ2＝4．58，P＝0．028）。혁란씨음성균시경、중도급성담관염적주요세균유별，다중세균감염시중도급성담관염세균감염적주요형식。세균대만고매소、아알배남화아미잡성등적민감솔교고。결론혁란씨양성균시급성담관염적주요병원균，응조기개입치료，급시병원균검측급약민시험，위림상치료제공준학방향。
Objective To profile the types of bacteria in bile culture and study their antibiotic sensitivity pattern in patients with varying de-grees of acute cholangitis and to provide data guidance for the prevention and treatment of bacterial infection.Methods The clinical data of 230 patients with acute cholangitis who were admitted to our hospital from April 2010 to April 2014 were retrospectively analyzed.Classifica-tion of pathogenic bacteria and the antibiotic sensitivity test in bile cultures were performed using VITEK 2 Compact Biomerieux microbiologi-cal system.Results Within the 230 patients,172 tested positive for biliary bacteria,and the positive rate was 74.78%(172/230).There were 237 strains of pathogenic bacteria,including 135 strains of Gram-positive bacteria (56.96%),comprised mainly of Enterococcus and Staphylococcus aureus,96 strains of Gram-negative bacteria (40.5 1%),comprised mainly of Pseudomonas aeruginosa,Escherichia coli, and Klebsiella pneumonia,and 6 strains of fungi (2.53%),comprised mainly of yeast.Significant difference in the positive rate of bacteria was detected between patients with mild and severe cholangitis (χ2 =4.58,P =0.028).Gram-negative bacteria were the predominant i-solates in patients with mild and moderate acute cholangitis,while multiple bacterial infection was more common in patients with severe cholangitis.Biliary bacteria had a higher rate of susceptibility to vancomycin,imipenem,and amikacin compared with other antibiotics. Conclusion Gram-positive bacteria are the predominant pathogens in acute cholangitis.Early detection,immediate intervention,and ac-curate drug susceptibility test should be implemented at regular intervals to direct effective clinical therapy.
