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目的分析胆道感染的菌群分布及耐药性特点,为临床选用抗菌药物提供依据。方法按照《全国临床检验操作规程》要求操作,用法国生物梅里埃公司的VITEK-32细菌鉴定仪鉴定菌种,采用K-B法做药敏试验,对临床分离的253株胆道感染病原菌进行鉴定及药物敏感试验。结果在分离的253株病原菌中,革兰阴性菌173株(68.4%),革兰阳性菌74株(29.2%),真菌6株(2.4%);革兰阴性菌以大肠埃希菌为主,革兰阳性菌以肠球菌属为主;检出产超广谱β-内酰胺酶(ESBLs)菌32株,其中大肠埃希菌产ESBLs24株,占75.0%,肺炎克雷伯菌产ESBLs8株,占25.0%。结论胆道系统感染的病原菌分布广泛,有些菌株产生多药耐药性;建议临床医师重视细菌学培养,用药敏结果指导临床合理用药,以减少ESBLs菌株的产生。
Objective To analyze the flora distribution and drug resistance of biliary tract infection and provide basis for clinical use of antimicrobial agents. Methods According to the requirements of the “National Clinical Laboratory Procedures”, the strain was identified by the VITEK-32 bacterial identification instrument of French bioMérieux and KB method was used for drug susceptibility testing. 253 clinical isolates of biliary tract infection were identified and the drug Sensitive test. Results Among the 253 isolated pathogens, 173 (68.4%) were Gram-negative bacteria, 74 (29.2%) were Gram-positive bacteria and 6 (2.4%) were Gram-negative bacteria. Gram-negative bacteria were mainly Escherichia coli , Gram-positive bacteria were Enterococcus; 32 ESBLs producing strains were detected, of which ESBLs was produced by Escherichia coli in 24 strains (75.0%) and Klebsiella pneumoniae producing ESBLs8 Strain, accounting for 25.0%. Conclusion The pathogens of biliary tract infection are widely distributed, and some strains have multidrug resistance. It is suggested that clinicians should pay more attention to bacteriological culture and guide clinical rational use of drug sensitivity to reduce the production of ESBLs strains.