Malignant Obstructive Jaundice Bile Bacteria Positive Researchand The Analysis Of Multiple Factors

Objective:Analysis of malignant obstructive jaundice bile bacteria positive rate;The distribution of pathogenic microorganisms; The incidence of secondary biliary tract infection;Screening of malignant obstructive jaundice secondary biliary postoperative infection of related factors;Explore the antibiotic use policies for MOJ patients. Methods:Selected during January 2014- January 2014 jilin university first hospital, Bethune at the records of 156 cases of liver and gallbladder surgery subject MOJ no symptoms in patients with biliary tract infection,With 90 cases male patients, 66 patients with women, Aged 35 to 74 years old, the median age at the age of 61. All cases have been history, lab, imaging diagnosis of the malignant tumor. In the operation take out 5 ml bile were respectively. Collect the information of gender, age, obstruction time, Tumor obstruction position,TBIL,Ca19-9,Child-Pugh score. and results of bile culture for Logistic multiplicity。 Results:There are 156 patients with malignant biliary obstruction in the study. There was no growth on bile culture in 60.9%patients(95/156). 39.1% patients had a positive bile culture(61/156) and 62 strains of microorganism were identified. There were 34patients(21.8%) diagnosed by biliary infection. Gram-positive bacteria account for 24.2%and Gram-negative bacteria account for 72.6%.The hospital patients with biliary tract infection pathogenic bacteria in bile is still mainly gram-negative bacteria;Top three pathogen is Time for e. coli, excrement enterococcus, with klebsiella pneumoniae pneumonia subspecies. E. coli to imine south, Shu Pu deep culture, piperacillin/he thiazole bajotham, cefoxitin, are the percentages of 0, clinical is recommended.Klebsiella pneumoniae in low levels of antibiotics to ampicillin,levofloxacin resistant rate>50%, the other common antibiotics sensitivity 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, ring thiazole amine irologic resistance is less than fifteen percent, clinical can choose. The risk factor of biliary system infection include age(X2=6.609,p=0.010)、site of obstruction(X2=6.511,p =0.011)、Child-Pugh score(X2=4.078,p=0.043), results of bile culture(X2=18.099、p<0.001).And results of Logisticmultiplicity is the Child-Pugh score and results of bile culture. Conclusions:39.1% patients had a positive bile culture and 62 strains of microorganism were identified. There were 34patients(21.8%) diagnosed by biliary infection. The hospital patients with biliary tract infection pathogenic bacteria in bile is still mainly gram-negative bacteria;Top three pathogen is Time for e. coli, excrement enterococcus, with klebsiella pneumoniae pneumonia subspecies. E. coli to imine south, Shu Pu deep culture, piperacillin/he thiazole bajotham, cefoxitin, are the percentages of 0, clinical is recommended.Klebsiella pneumoniae in low levels of antibiotics to ampicillin,levofloxacin resistant rate>50%, the other common antibiotics sensitivity 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, ring thiazole amine irologic resistance is less than fifteen percent, clinical can choose. The risk factor of biliary system infection include age 、 site of obstruction、Child-Pugh score,results of bile culture.And results of Logisticmultiplicity is the Child-Pugh score and results of bile culture.