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急性胆管炎患者的致病微生物和相关临床特征分析OA

Analysis of pathogenic microorganisms and related clinical features in patients with acute cholangitis

中文摘要英文摘要

目的 分析急性胆管炎患者的致病微生物和相关临床特征.方法 收集并分析 2019-2022 年海宁市人民医院 229例急性胆管炎患者的胆汁培养结果和相关临床资料.结果 229 例患者中 160 例胆汁培养结果阳性(69.87%),其中 58例为多种细菌混合感染.160 例阳性胆汁标本共分离出病原菌 227 株,其中革兰阴性菌 136 株(59.91%),革兰阳性菌79 株(34.80%),真菌 12 株(5.29%);混合感染以大肠埃希菌与屎肠球菌混合最为常见(10/58,17.24%).革兰阴性菌对阿米卡星、替加环素的敏感度最高,而革兰阳性菌对利奈唑胺、万古霉素和替加环素高度敏感.既往胆道手术史和肝硬化均是发生胆道感染的独立危险因素(P<0.05);肝硬化是发生混合感染的独立危险因素(P<0.05).结论 急性胆管炎致病微生物分布复杂,且对常用抗菌药物有一定的耐药性.对既往有胆道手术史、肝硬化、慢性肾功能不全的急性胆管炎患者,临床医生应予以高度关注,合理选择初始抗菌药物.

Objective To analyze pathogenic microorganisms and related clinical features in patients with acute cholangitis.Methods The pathogenic microorganism culture results and related clinical data of 229 patients with acute cholangitis in People's Hospital of Haining from 2019 to 2022 were collected and analyzed.Results Among 229 patients,160(69.87%)patients were positive in bile culture,of which 58 patients were infected with multiple bacteria.A total of 227 strains of pathogenic bacteria were isolated from 160 positive bile specimens,of which 136(59.91%)strains were Gram-negative,79(34.80%)strains were Gram-positive and 12(5.29%)strains were fungi.Escherichia coli mixed with Enterococcus faecium was the most common infection(10/58,17.24%).The susceptibility rate of Gram-negative bacteria to amikacin and tigecycline was the highest,and Gram-positive bacteria were highly sensitive to linezolid,vancomycin and tigecycline.Previous biliary surgery history and cirrhosis were independent risk factors for biliary tract infection(P<0.05).Cirrhosis was an independent risk factor for co-infection(P<0.05).Conclusion The pathogenic microorganisms of acute cholangitis are complex in distribution and have some resistance to common antibiotics.Clinicians should pay close attention to patients with acute cholangitis who have a history of biliary tract surgery,cirrhosis and chronic renal insufficiency,and rationally select initial antibiotics.

郝素平;顾蓓青;郝建宏

海宁市人民医院检验科,浙江海宁 314400海宁市人民医院肝胆外科,浙江海宁 314400

临床医学

急性胆管炎;致病微生物;抗菌药物;临床特征

Acute cholangitis;Pathogenic microorganisms;Antibacterial agents;Clinical characteristics

《中国现代医生》 2024 (013)

25-28 / 4

10.3969/j.issn.1673-9701.2024.13.007

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