Risk Factors And Drug Resistance Of Gram-negative Bacilli Producing Extended Spectrum β-lactamase In Biliary Tract Infection Patients

OBJECTIVE: To understand the distribution of extended spectrum β-lactamase(Extended spectrum β-lactamase)gram-negative bacilli infections in patients with biliary tract infections in our hospital,analyze related risk factors and antibiotic resistance,for clinical use Treatment reference.METHODS: The electronic information medical record system of Shengjing Hospital of China Medical University was used to collect the cases with positive results of bile bacteria culture.The results showed that there were 105 strains of Gram-negative bacilli,accounting for 56.45%,which were divided into ESBLs(+)group and ESBLs(-)group according to whether they produced ESBLs.Record all information in both groups,including sex,age,diabetes history,history of biliary tract disease and operation,invasive tube insertion.we,merging,liver cirrhosis,culture history of antibiotic use within three months before,whether the pathogenesis of infectious shock,ICU hospitalization days,preoperative blood routine and biochemical,biliary infection and bile culture after treatment after admission materials of drug susceptibility test results.Compare the data of the two groups.RESULTS: Single factor analysis found that the age(≧ 60 years old),gender(male),history,invasive tube insertion.we lying in bed,white blood cells,hemoglobin,red blood cell volume,urea nitrogen,albumin,a total of eight risk factors for producing ESBLs gram-negative bacilli(P < 0.05),statistically significant,multi-factor analysis found that bacterial culture before has a history of antibiotic use,amalgamative liver cirrhosis is the infection of biliary tract of ultra broad spectrum beta lactamase negative bacillus risk factors(P < 0.05).Aminoglycosides,cephalomycins and carbapenems were highly sensitive to the broad-spectrum β-lactamase-negative bacilli producing biliary tract infection.CONCLUSION: Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii were the most common pathogenic bacteria.Previous antibiotic use and cirrhosis were independent risk factors for ESBL.Gram-negative bacteria producing ESbls were highly sensitive to amicacin,cefotetan,hydromolenems and tegacycline,while second-generation cephalosporins were all resistant,third-generation cephalosporins such as ceftriaxone sodium,ceftazidime,cefoperazone/sulbactam sodium,fourth-generation cephalosporins and quinolones had high resistance rates.