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急性胆道感染是一种广义的名称,它包括各种原因引起的胆囊和胆管系统的炎症,通常以蛔虫、结石及继发的大肠杆菌感染最为多见,是外科常见的急腹症之一,其发病率在我国有的地区仅次于阑尾炎而居第二位。一、胆道感染常见致病菌耐药性变迁情况正常胆汁是无菌的,当胆汁流发生梗阻时则可培养出细菌。胆道部分梗阻者胆汁培养细菌阳性率为60～80％,完全梗阻者阳性率为10％。慢性胆囊炎者25～50％胆囊壁细菌培养呈阳性。因胆石引起的黄疸患者胆汁培养细菌阳性率为72％,而恶性物引起的阻塞性黄疸患者仅36％胆汁中可培养出细菌。分离出来的细菌中,最常见的是大肠杆菌,其次为变形杆菌、付大肠杆菌、产气杆菌、绿脓杆菌、粪链球菌葡萄和球菌等,有时也可为其他的需氧菌或厌氧菌(表1)。
Acute biliary tract infection is a broad name, which includes inflammation of the gallbladder and bile duct system caused by various causes, usually the most common infection with roundworms, stones and secondary E. coli, is one of the common acute abdomen in surgery, Its incidence is second only to appendicitis in some areas of our country. First, the common pathogens of biliary tract infection Resistance changes Normal bile is sterile, when the bile flow obstruction can be cultured bacteria. Biliary obstruction in bile culture bacteria positive rate of 60 to 80%, complete obstruction positive rate was 10%. Chronic cholecystitis 25 ~ 50% gallbladder wall bacterial culture was positive. Patients with jaundice caused by gallstone had a positive rate of bile culture of 72%, whereas only 36% of patients with obstructive jaundice caused by gallstone developed bacteria in bile. Isolated bacteria, the most common is Escherichia coli, followed by Proteus, pay E. coli, Aerobacter aerogenes, Pseudomonas aeruginosa, Streptococcus faecalis grapes and cocci, and sometimes other aerobic bacteria or anaerobic Bacteria (Table 1).