Patients With Biliary Tract Infection Of Pathogenic Bacteria In Bile Distribution And Changes Of Drug Sensitivity Analysis

Objective: to study the changes of biliary infection in the patientswith biliary bacteria spectrum and drug sensitivity of change, to guideclinical medication.Methods: based on method: sterile syringes extraction in patients withbiliary timely inspection for bacterial culture, the commonly used methodin clinical is bile collection (1)ERCP (ERCP), the patient of antispasmodic drugs in sedated settlementAfter the duodenum mirror line ERCP, when the lens to the duodenum,through duodenum nipple into the bile duct intubation.Before theinjection of contrast agent, using a disposable sterile syringe pump bile2~5ml, sterile tube injection has prepared immediately, inoculation and in2hours, bacterial culture and drug sensitivity analysis [2]percutaneous biliary drainage (PTCD), generally located in undercolour to exceed, choose the puncture point according to thecircumstance, conventional disinfection shop towels, knife broken skinafter anesthesia is about0.2cm, to pass through the liver in colour toexceed PTCD needle puncture percutaneous guided into the bile duct,exit the needle core, syringe needle sheath, take aseptic bile, injection ofcontrast agent show biliary system.PTCD safety, small trauma, fewercomplications.T tube drainage of biliary postoperative bile duct exploration of biliary infection in patients with T tube drainageTraining methods and standards of bile collection after bile inoculated onblood plate37℃train12to24h and purification with reference to theministry of health clinical testing center "test procedures".The FrenchVITEK-32bacteria automatic analysis system of gram-negative bacteriaidentification card GNI, GPI gram-positive bacteria identification card foridentification.Using VITEK-32full-automatic microbial analyzerdecongestion quick card GNS-143, GPS-110, testing the drugresistance of pathogenic bacteria.A database of statistical analysis used EpiData3.1, SPSS18.0software forgeneral descriptive analysis.Results: the proportion of G-bacteria have obvious drop, six years ago(78%),2011-2012G-bacteria accounted for73.9%, G+bacteria bothno obvious changes, compared to six years ago G+bacteria accountedfor22%, the proportion is22.4%, biliary infection, mixed infection earlierI ncrease, and the number of fungal infection increased, currentlyaccounts for3.7%, and there are cases of fungal infection is commonlyand bacteria mixed infection,Several main G-bacteria resistant rate is the lowest imine culture south,followed by ShuPu depth, tobramycin, cefepime, Amy card magnitudevancomycin for G+dung enterococcus, excrement enterococcus effect isbest, bacteria resistant rate to zero in to its clinical effect is best, bacteriaof gentamicin, high concentration streptomycin, ciprofloxacin, rifampicin,rina thiazole amine irologic resistance is less than fifteen percent,.Drug susceptibility test results showed that fungus of fluorine tumbled down, FuLiKang sensitive, and are generally resistant to amphotericin Bshows,Conclusion:1. The hospital patients with biliary tract infectionpathogenic bacteria in bile is still mainly gram-negative bacteria;Top fourpathogenicTime for e. coli (36.4%), excrement enterococcus (11.67%), withklebsiella pneumoniae pneumonia subspecies (14.9%), sewer, e. coli(8.1%).Freund’s7.0%citric acid bacilli.2. In the antibiotic resistant experiments, several main G-bacteriaresistant rate is the lowest imine culture south, followed by ShuPu depth,tobramycin, cefepime, Amy card magnitude.Sewer enterobacter in addition to imine south, piperacillin/he azoletemple, amikacin, tobramycin, low percentages,<50%, clinical effect isbetter.E. coli to imine south, ShuPu deep culture, piperacillin/he thiazole bajotham, cefoxitin, are the percentages of0, clinical is recommended.Klebsiella pneumoniae in low levels of antibiotics to ampicillin,levofloxacin resistant rate>50%, the other common antibioticssensitivity of acceptable;Vancomycin for G+dung enterococcus, excrement enterococcus effectis best, bacteria resistant rate to zero in to its clinical effect is best,bacteria of gentamicin, high concentration streptomycin, ciprofloxacin,rifampicin, rina thiazole amine irologic resistance is less than fifteen percent, clinical can choose.Fungi susceptibility test results show that the fungus to fluconazoletumbled down, FuLiKang sensitive,.3, treatment of biliary tract infection first consider the high sensitivity toantibiotics of G-bacteria, can choose ShuPu deep in patients with mild or(and) amikacin, critically ill patients can choose imine culture south orbake to beauty.Clinical effect is not ideal, if three days should consider G+bacteria infection or with G+bacteria infection, can convert orcombination of G+bacteria sensitive antibiotics, such as vancomycin ortheir stead ning.Use of antibiotics for more than13days later shouldconsider the combination of antifungal drugs v Anne.