胆总管结石患者胆汁病原菌分布特点及耐药性分析.

Objective: To investigate the distribution characteristics of bile pathogenic and analysis of drug resistance in patients with choledocholithiasis. Methods: A total of 160 cases of choledocholithiasis combined with biliary tract infection, who were treated in the First Affiliated Hospital of Chengdu Medical College fromJune 2016 to June 2017, were selected as research subjects. All the patients were treated with retrograde endoscopic cholangiopancreatography (ERCP) and extracted the bile samples and bacterial culture and drug resistance experiment were conducted, the distribution characteristics and drug resistance of bile pathogens were analyzed. Among 160 patients, 117 patients (73.13%) were detected pathogenic bacteria, and 130 bacteria were cultured, of which 13 were infected by two bacteria; there were 95 strains of Gram-negative bacteria (73.08%), 31 strains of Gram-positive bacteria (23.85%), 4 strains of fungi (3.08%). The first six pathogens fromhigh to low were in turn: escherichia coli, klebsiella pneumoniae, enterobacter cloacae, enterococcus faecium, pseudomonas aeruginosa and Enterococcus faecalis. The resistance rates of Gram-negative bacteria to imipenem, meropenem, Amikacin, tazobactam, cefepime and three or four generation cephalosporin were lower, the resistance rates to ceftriaxone, ciprofloxacin, levofloxacin, piperacillin and ampicillin were higher. The resistance rates of Gram positive bacteria to Lakaoning, vancomycin, linezolid and other were lower, the resistance rates to tetracycline, ciprofloxacin, levofloxacin, clindamycin and ampicillin were higher. The resistance rates of fungi to ketoconazole, itraconazole and fluconazole were lower, and the resistance rate to amphotericin B was higher. Conclusions: The main pathogenic bacteria in the bile of patients with choledocholithiasis are Gram-negative bacteria, the second is Gram-positive bacteria. The pathogenic bacteria showed different resistance to various antibacterials; therefore, in the clinical treatment, drugs should be reasonably chosen according to the results of drug sensitivity test. [ABSTRACT FROM AUTHOR]