Bile Bacterial Investigation Of Patients Suffer From Cholelithiasis In Qingdao

OBJECTIVE:To survey the characteristics and drug sensitive of biliary bacteriology for the purpose of effective antibiotics application.METHODS:the cases of 183 cases' bile were collected,germ culture and antibiotic susceptibility were carried out.And survey the relation of sex,age,season,medication and intercurrent diseases to the germiculture results.The patients were divided into different groups according to symptom, position of stone and surgical operation history.RESULTS:117 cases were positive in biliary bacterial culture with a positive rate of 63.9%.There were 81 Gram-negative bacteria(64.8%),40 Gram-positive bacteria(32.0%)and 4fungus(3.20%) in 125 pathogenic microbes.The bile positive germiculture rate of cholangiocarcinoma was 35.7%.183 cases were divided into gerontism group(≥60y) and non-gerontism group(＜60y),the bile positive germiculture rate was 73.9%and 54.7%.Of the 97 cases female patients,65 showed a positive result(67.0%),and the positive rate of male patinets was 60.5%(52/86),χ~2=0.847,P＞0.05.In different positions,the positive rate of patients with cholecystolithiasis was the lowest(17.2%),and calculus of intrahepatic and extrahepatic duct had the higest positive rate(89.4%),χ~2=30.805,P＜0.01.The main bacteria were lowly resistant to imipenem,meropenem,vancomycin,teicoplanin,amikacin and cefepime,but has a high resistant rate to amoxicillin,piperacillin,ticarcillin and ciprofloxacin.CONCLUSIONS:There was an increasing percentage of positive cultures according to the severity of the disease in patients with bile duct stones.Age and history of biliary tract surgery had important influence.The bile positive germiculture rate of cholangiocarcinoma was lower.The most common bacteria in bile is escherichia coli,klebsiella spp and enterococcus faecalis,they have a lowly resistance rate to vancomycin,imipenem and amikacin.But have a high resistant rate to most common antibiotics.