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目的了解胆石症合并胆道感染患者病原菌分布与临床特征的关系,以期能为治疗提供参考。方法选取2012年1月-12月医院胆石症合并胆道感染120例患者为研究对象,术中取得胆汁进行病原菌培养及药物敏感试验检查,并分析与临床特征间的关系,数据采用SPSS 17.0软件进行统计分析。结果 120例患者取得的胆汁标本中病原菌培养阳性者97例,培养阳性率80.83%,共培养出病原菌112株,其中革兰阴性菌93株,占83.04%;革兰阴性菌及革兰阳性菌均对临床常用的抗菌药物存在一定的耐药性;患者年龄≥60岁、有食用生鱼史、胆道手术史、肝病史时胆汁病原菌培养阳性分别占50.52%、59.79%、70.10%、67.01%,差异有统计学意义(P<0.05)。结论胆石症合并胆道感染时胆汁感染病原菌以革兰阴性菌为主,主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌及肠球菌属,对临床常用抗菌药物均有一定耐药性,胆道感染与食用鱼生史、胆道手术史及肝炎病史存在一定关系。
Objective To understand the relationship between the distribution of pathogens and the clinical features in patients with cholelithiasis and biliary tract infection, so as to provide reference for the treatment. Methods A total of 120 patients with cholelithiasis and biliary tract infection from January 2012 to December 2012 in our hospital were enrolled in this study. Pathological culture and drug susceptibility tests were performed to obtain bile during operation. The relationship between them and clinical features was analyzed. The data were analyzed by SPSS 17.0 software Statistical Analysis. Results Among the 120 patients, 97 cases were positive for pathogen culture, the positive rate was 80.83%. A total of 112 pathogenic bacteria were co-cultivated, of which 93 strains were Gram-negative bacteria, accounting for 83.04%. Gram-negative bacteria and Gram-positive bacteria All of them had some resistance to commonly used antibacterial drugs in clinical practice. The patients were older than 60 years old, with the history of eating raw fish, the history of biliary tract surgery, the positive rate of bile pathogen culture in the history of liver disease accounted for 50.52%, 59.79%, 70.10% and 67.01% , The difference was statistically significant (P <0.05). Conclusions Cholelithiasis with biliary tract infection is mainly caused by gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Enterococcus, and has certain resistance to common antibacterial drugs Drug resistance, biliary tract infections and fish history, history of biliary surgery and hepatitis history there is a certain relationship.