胆囊结石伴胆囊炎患者胆汁中病原菌的特点及耐药性分析

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Abstract Objective To investigate the characteristics and drug resistance of pathogenic bacteria in the bile of patients with gallbladder stones and cholecystitis. Methods A total of 182 patients with gallbladder stones and cholecystitis who were admitted to Beijing Liangxiang Hospital from June 2017 to June 2020 were selected as the research objects and the characteristics of pathogenic bacteria in their bile and the drug resistance of the main pathogens were analyzed. Results A total of 191 pathogenic bacteria were detected, including 130 Gram-negative bacteria (68.06%), 53 Gram-positive bacteria (27.75%), and 8 fungi (4.19%). Enterobacter Cloacae was naturally resistant to Ampicillin/Ceftazolin, Ampicillin/Sulbactam. Klebsiella Pneumoniae was naturally resistant to Ampicillin, Cefuroxime and Ceftriaxone.The resistance rates of Escherichia Coli to Ampicillin/Sulbactam, Cefotaxime, Ampicillin, Cefazolin, Cefuroxime, Ceftriaxone and piperacillin were ＞50%. The resistance rates of Enterobacter Cloacae resistant to Aztreonam, Ceftazidime,Cefotaxime, Cefuroxime, Ceftriaxone, Amoxicillin, Clavulanate Potassium and Nitrofurantoin were all ＞60%. Klebsiella Pneumoniae resistance to common antibacterial drugs was less than 40%. The drug resistance rates of the main Gramnegative bacteria to Meropepenem and Amikacin were all less than 10%. The resistance rates of Enterococcus Faecalis to Ampicillin and nitrofurantoin were 0%. The main Gram-positive bacteria resistant to Linezolid, Vancomycin and Tigecycline, the rates were all 0%, and the resistance rates to Clindamycin and Erythromycin were both ＞85%. The resistance rate of Enterococcus Faecium to Rifampin was ＞85%. Conclusion Bile culture of gallbladder stones with cholecystitis is mainly infected by gram-negative bacteria. There are obvious differences in drug resistance of different pathogens. It is necessary to select antibiotics reasonably according to the results of drug susceptibility, improve the therapeutic effect, and be alert to the emergence of multi-drug resistant bacteria.

Key words： Cholecystitis Gallbladder stones Characteristics of pathogenic bacteria Drug resistance

Received: 12 January 2021

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