中华医院感染学杂志
中華醫院感染學雜誌
중화의원감염학잡지
Chinese Journal of Nosocomiology
2015年
9期
1989-1990,1993
,共3页
胆石症%医院感染%胆汁%血培养%临床研究
膽石癥%醫院感染%膽汁%血培養%臨床研究
담석증%의원감염%담즙%혈배양%림상연구
Cholelithiasis%Nosocomial infection%Bile%Blood culture%Clinical study
目的：分析胆石症患者胆道感染的病原菌分布及耐药性，为临床合理用药提供参考依据。方法选取2013年254例胆石症患者，采集发生胆道感染患者静脉血和胆汁，对其病原菌分布及其耐药性进行筛查，采用SPSS13．0软件进行统计分析。结果254例胆石症患者发生胆道感染164例，感染率为64．57％；血培养阳性90例，阳性率为35．43％，胆汁培养阳性164例，阳性率为64．57％，胆汁培养的阳性率明显高于血培养，差异有统计学意义（ P＜0．05）；胆汁培养出病原菌164株，其中革兰阳性菌68株占41．46％，革兰阴性菌96株占58．54％；血液培养出病原菌90株，其中革兰阳性菌36株占40．00％，革兰阴性菌54例占60．00％，以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、阴沟肠杆菌、粪肠球菌为主；革兰阳性菌对舒巴坦、红霉素的耐药率较高，＞85．00％，对万古霉素、呋喃妥因敏感，耐药率为0；革兰阴性菌耐药性严重，对常用抗菌药物的耐药率均＞50．00％，对氨苄西林的耐药率达100．00％，对亚胺培南敏感，耐药率＜4．00％。结论胆石症合并胆道感染患者胆汁培养的阳性率较高，病原菌对常用抗菌药物均产生了较严重的耐药性，临床应根据药敏试验结果合理选用抗菌药物。
目的：分析膽石癥患者膽道感染的病原菌分佈及耐藥性，為臨床閤理用藥提供參攷依據。方法選取2013年254例膽石癥患者，採集髮生膽道感染患者靜脈血和膽汁，對其病原菌分佈及其耐藥性進行篩查，採用SPSS13．0軟件進行統計分析。結果254例膽石癥患者髮生膽道感染164例，感染率為64．57％；血培養暘性90例，暘性率為35．43％，膽汁培養暘性164例，暘性率為64．57％，膽汁培養的暘性率明顯高于血培養，差異有統計學意義（ P＜0．05）；膽汁培養齣病原菌164株，其中革蘭暘性菌68株佔41．46％，革蘭陰性菌96株佔58．54％；血液培養齣病原菌90株，其中革蘭暘性菌36株佔40．00％，革蘭陰性菌54例佔60．00％，以大腸埃希菌、肺炎剋雷伯菌、銅綠假單胞菌、陰溝腸桿菌、糞腸毬菌為主；革蘭暘性菌對舒巴坦、紅黴素的耐藥率較高，＞85．00％，對萬古黴素、呋喃妥因敏感，耐藥率為0；革蘭陰性菌耐藥性嚴重，對常用抗菌藥物的耐藥率均＞50．00％，對氨芐西林的耐藥率達100．00％，對亞胺培南敏感，耐藥率＜4．00％。結論膽石癥閤併膽道感染患者膽汁培養的暘性率較高，病原菌對常用抗菌藥物均產生瞭較嚴重的耐藥性，臨床應根據藥敏試驗結果閤理選用抗菌藥物。
목적：분석담석증환자담도감염적병원균분포급내약성，위림상합리용약제공삼고의거。방법선취2013년254례담석증환자，채집발생담도감염환자정맥혈화담즙，대기병원균분포급기내약성진행사사，채용SPSS13．0연건진행통계분석。결과254례담석증환자발생담도감염164례，감염솔위64．57％；혈배양양성90례，양성솔위35．43％，담즙배양양성164례，양성솔위64．57％，담즙배양적양성솔명현고우혈배양，차이유통계학의의（ P＜0．05）；담즙배양출병원균164주，기중혁란양성균68주점41．46％，혁란음성균96주점58．54％；혈액배양출병원균90주，기중혁란양성균36주점40．00％，혁란음성균54례점60．00％，이대장애희균、폐염극뢰백균、동록가단포균、음구장간균、분장구균위주；혁란양성균대서파탄、홍매소적내약솔교고，＞85．00％，대만고매소、부남타인민감，내약솔위0；혁란음성균내약성엄중，대상용항균약물적내약솔균＞50．00％，대안변서림적내약솔체100．00％，대아알배남민감，내약솔＜4．00％。결론담석증합병담도감염환자담즙배양적양성솔교고，병원균대상용항균약물균산생료교엄중적내약성，림상응근거약민시험결과합리선용항균약물。
OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing biliary tract in‐fections in the patients with cholelithiasis so as to provide guidance for reasonable clinical use of antibiotics . METHODS A total of 254 cholelithiasis patients who were treated in 2013 were enrolled in the study ,then the ve‐nous blood and bile were collected from the patients with biliary tract infections ,the distribution and drug resist‐ance of the pathogens were observed ,and the statistical analysis was performed with the use of SPSS13 .0 soft‐ware .RESULTS The biliary tract infections occurred in 164 of 254 patients with cholelithiasis ,with the infection rate of 64 .57% .Totally 90 cases were positive for blood culture with the positive rate of 35 .43% ,and 164 cases were positive for bile culture with the positive rate of 64 .57% ,the positive rate of the bile culture was significant‐ly higher than that of the blood culture(P<0 .05) .Totally 164 strains of pathogens were cultured from the bile , including 68 (41 .46% ) strains of gram‐positive bacteria and 96 (58 .54% ) strains of gram‐negative bacteria;total‐ly 90 strains of pathogens were cultured from the venous blood ,including 36 (40 .00% ) strains of gram‐positive bacteria and 54 (60 .00% ) strains of gram‐negative bacteria ,dominated by the Escherichia coli ,K lebsiella pneu‐moniae ,Pseudomonas aeruginosa ,Enterobacter cloacae ,and Enterococcus f aecalis .The drug resistance rates of the gram‐positive bacteria to sulbactam and erythromycin were more than 85 .0% ,and the drug resistance rates to vancomycin and nitrofurantoin were 0 .The drug resistance rates of the gram‐negative bacteria to the commonly used antibiotics were more than 50 .00% ,the drug resistance rate to ampicillin was as high as 100 .00% ,and the drug resistance rate to imipenem was less than 4 .00% .CONCLUSION The positive rate of bile culture is high a‐mong the cholelithiasis patients complicated with biliary tract infections .The pathogens are highly resistant to the commonly used antibiotics ,and it is necessary for the hospital to reasonably use antibiotics based on the results of the drug susceptibility testing .
