中文摘要：

目的了解胆道感染病原菌的分布及其耐药性，为临床使用抗菌药物提供依据。方法医院2008年1月-2012年8月的胆汁标本经BacT／ALERT120全自动血培养仪培养检测，对检出的病原菌采用VITEK-2Compact全自动微生物鉴定药敏仪进行细菌鉴定及药敏分析。结果共分离到病原菌305株，其中革兰阴性杆菌占69．84％，革兰阳性球菌占27．54％，真菌占2．62％，排名前5位病原菌依次为大肠埃希菌、肺炎克雷伯菌、粪肠球菌、屎肠球菌、铜绿假单胞菌，分别占29．18％、12．13％、11．48％、6．89‰、5．90％，大肠埃希菌及肺炎克雷伯菌产超广谱β-内酰胺酶的检出率分别为47．19％和21．62％；大肠埃希菌对青霉素类、喹诺酮类、部分第三代头孢菌素类的耐药率较高，为48．86％～69．32％，对阿米卡星、亚胺培南有较低的耐药率；铜绿假单胞菌对阿米卡星、庆大霉素和哌拉西林／他唑巴坦的耐药率较低，〈12．00％，粪肠球菌对利奈唑胺的耐药率为2．94％，未检出对万古霉素、替考拉宁耐药的菌株；屎肠球菌对糖肽类药物的耐药率为4．76％～9．52％。结论医院致胆道感染病原菌以革兰阴性菌为主，混合感染多见，采用对大肠埃希菌耐药率低的广谱抗菌药物用于治疗胆道细菌感染。

英文摘要：

OBJECTIVE To investigate the distribution and drug resistance of pathogens causing biliary tract infections so as to provide guidance for clinical use of antibiotics. METHODS The bile samples that were collected from Jan 2008 to Aug 2012 were cultured with the use of BacT/ALERT120 automated blood culture system, then the isolated pathogens were identified by using VITEK 2 Compact automatic microorganism identification system, and the drug susceptibility testing was performed. RESULTS A total of 305 strains of pathogens have been isolated, among which the gram-negative bacilli accounted for 69.84%, the gram-positive bacteria 27.54%, the fungi 2.62% ; the Escheriehia coli, Klebsiella pneumoniae, Enteroccocus faecalis, Enteroccocus faecium, and Pseudo monas aeruginosa ranked the top 5 species of pathogens, accounting for 29.18%, 12.13 %, 11.48 %, 6.890%, and 5.90%, respectively. The detection rates of the extended-spectrum beta-lactamases （ESBLs）-producing E. coli and K. pneumoniae were 47.19% and 21. 62%, respectively. The drug resistance rates of the E. coli to penicillin, quinolones, and some of the third generation cephalosporins varied between 48.86% and 69. 32%, and the drug resistance rates to amikacin and imipenem were low; the drug resistance rates of the P. aeruginosa to amikacin, gentamicin, and piperacillin-tazobactam were less than 12.00% ; the drug resistance rate of the E. faecalis to lin ezolid was 2. 94%, and no strains resistant to vancomycin or teicoplanin have been detected; the drug resistance rate of the E. faecium to glycopeptides varied from 4.76% to 9.52%. CONCLUSION The gram-negative bacteria are the main pathogens causing biliary tract infections, and the mixed infections are common; the broad spectrum antibiotics susceptible to the E. coli are recommended for the treatment of biliary tract infections.