| 陈圣开,吴晓春,刘永.细菌性肝脓肿与胆道感染的病原菌及药敏试验比较分析[J].安徽医药,2020,24(5):981-985. |
| 细菌性肝脓肿与胆道感染的病原菌及药敏试验比较分析 |
| Comparative study of the pathogen and drug susceptibility test between bacterial liver abscess and biliary tract infection |
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| DOI：10.3969/j.issn.1009?6469.2020.05.034 |
| 中文关键词: 肝脓肿，化脓性 胆管疾病 抗菌药 微生物敏感性试验 集落计数，微生物 胆道感染 |
| 英文关键词: Liver abscess,pyogenic Bile duct diseases Anti?bacterial agents Microbial sensitivity tests Colony count, microbial Bacterial liver abscess |
| 基金项目: |
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| 摘要点击次数: 2011 |
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| 中文摘要: |
| 目的了解当前细菌性肝脓肿和胆道感染的病原菌及药敏试验结果差异，便于指导临床治疗。方法回顾性收集和分析 2012年 3月至 2018年 9月重庆市人民医院收治的 64例细菌性肝脓肿和 269例胆道感染病人的细菌培养和药敏试验资料及相关临床资料。结果细菌性肝脓肿检出细菌 52株(7种)包括肺炎克雷伯菌 31株(59.6%)、链球菌 8株(15.4%)、铜绿假单胞菌 7株(13.5%)、其他 6株(11.5%)其中革兰阴性菌占 78.8%兰阳性菌占 21.2%。胆道感染检出细菌 123株(13种)包括大肠埃希菌 47株(38.2%)、肺炎克雷伯0株(24.4%)、阴沟肠杆菌 13株(10.6%)、其他 33株(26.8%)其中革兰阴性菌占 81%，革兰阳性菌占 18.7%。细菌性肝脓肿的革兰阴性菌耐药率较低的抗生素包括:阿米卡星( 0.0%)、南( 0.0%)、亚胺培南(2.2%)、头孢他啶(4.4%)、头孢吡肟(4.4%)、氨曲南(6.7%)、哌拉西林 /他唑巴坦(8.9%)、头孢替坦(8.9%)、左氧氟沙星(8.9%)妥布霉素(11.1%)等，胆道感染革兰阴性菌耐药率较低的抗生素包括:阿米卡星( 0.0%)、厄他培南( 0.0%)、亚胺培南( 4.2%)、西林 /他唑巴坦，革，菌3，.3，厄他培，哌拉、(5.3%)、妥布霉素( 6.3%)等。两种感染多重耐药菌株比例分别为 38.5%、30.9%(P＞0.05)。结论两种感染的致病菌均以革兰阴性菌为主，但细菌性肝脓肿的致病菌以肺炎克雷伯菌最常见，胆道感染的致病菌以大肠埃希菌最常见。对两种感染的革兰阴性菌均较敏感的抗生素包括阿米卡星、厄他培南、亚胺培南、哌拉西林 /他唑巴坦、妥布霉素。不同之处在于:头孢他啶、头孢吡肟、头孢替坦、氨曲南和左氧氟沙星对引起细菌性肝脓肿的革兰阴性菌较敏感，但对引起胆道感染的革兰阴性菌敏感性较差。 |
| 英文摘要: |
| Objective To investigate the difference of pathogen and drug susceptibility test between bacterial liver abscess and bili?ary tract infection at present，so as to guide clinical therapy.Methods The clinical data of the bacterial culture and drug susceptibili?ty test etc.of 64 patients with bacterial liver abscess and 269 patients with biliary tract infection admitted to Chongqing General Hospi?tal from March 2012 to September 2018 were collected retrospectively and analysed.Results A total of 52 strains(7 types)of bacte? ria were isolated from pus or blood of the 64 cases of bacterial liver abscess，including 31 strains of Klebsiella pneumonia(59.6%)8 strains of streptococcus(15.4%)，7 strains of Pseudomonas aeruginosa(13.5%)，and 6 other strains(11.5%)，among which 78.8%(41/，52)were Gram?negative bacteria and 21.2%(11/52)were Gram?positive.A total of 123 strains(13 types)of bacteria were isolated from bile of the 269 cases of biliary tract infection，including 47 strains of Escherichia coli(38.2%)，30 strains of Klebsiella pneumo? nia(24.4%)，13 strains of Enterobacter cloacae(16.6%)and 33 other strains(26.8%)，among which 81.3%(100/123)of the bacteria were Gram?negative，18.7%(23/123)were Gram?positive.The antibiotics with low resistance to Gram?negative bacteria from bacterial liver abscess included Amikacin(0.0%)Ertapenem(0.0%)Imipenem(2.2%)Ceftazidime(4.4%)Cefepime(4.4%)Aztreonam(6.7%)dium Tobramycin.9%)Cefotetan9%)Levofloxacin.9%)，Tobramycin11.1%)， n included Amikacin(0.0%)，ErtapenemPiperacillinSodium/TazobactamSo，(8，(8.，(8，(，etc.Thean，tibioticswithlowresistancetoGram?negativebacteriafromb，iliarytractinfectio，(0.0%)Imipenem(4.2%)，Piperacillin Sodium/Tazobactam Sodium(5.3%)，Tobramycin(6.3%)，etc.The proportions of the multidrug? trains in the two types of infection were 38.5% and 30.9%，respectively(P＞0.05).Conclusion Gram?negative bacteria are resistants， |
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