胆汁分离细菌种类及主要分离菌株耐药性分析

目的了解2000年至2008年临床胆汁普通培养分离细菌的种类,并分析主要分离菌株的耐药性。方法回顾性分析近9年710例胆囊炎和胆囊结石患者胆汁普通培养分离细菌的分布情况及耐药率;用微量稀释法进行药物敏感性测定。结果710例患者胆汁培养共分离出细菌435株,检出率为61.27%,前5位分别为大肠埃希菌、肠球菌、假单胞菌、肺炎克雷伯菌和凝固酶阴性葡萄球菌。革兰阴性杆菌对亚胺培南、阿米卡星的耐药率均低于10%,对常用青霉素类和头孢菌素类抗生素耐药率超过50%。结论胆汁分离细菌以肠道细菌为主,阿米卡星可以作为经验治疗的首选药物。

Kinds of bacteria isolated from bile and antimicrobial resistance of predominant strains

Objective To investigate kinds of bacteria isolated from the common culture of bile during 2000 to 2008 and analyze the antimicrobial resistance of predominant strains.Method The distribution and drug resistance of bacteria isolated from the common cultures of biles from 710 patients with cholecystitis and cholecystolithiasis within 9 years were analyzed retrospectively. The antimicrobial sensitivity tests were performed by micro-dilution method.Result A total of 435 strains were isolated.The positive rate was 61.27%,with the top five bacteria being Escherichia coli, Enterococci, Pseudomonas, Klebsiella pneumonia and coagulase negative Staphylococcus respectively.The antimicrobial resistance rates of gram negative bacilli against Imipenem and Amikacin were lower than 10% while their resistance rates against penicillins and cephem antibiotics were higher than 50%.Conclusion Bacteria isolated from the common culture of bile is mainly enteric bacteria. Amikacin may be the drug of choice for experiential therapy.