Distribution,Drug Resistance Characteristics And Antibacterial Efficacy Of Bile Pathogens In Patients With Acute Obstructive Cholangitis

Objective To study the bile microbial culture and antibiotic sensitivity of acute obstructive cholangitis,so as to provide reference value for clinical disease treatment.Methods 321 patients with choledocholithiasis who underwent ERCP in our hospital from January 2018 to January 2021 were subjected to bile microbial culture,they were divided into biliary tract infection and non biliary tract infection.Further bile microbial culture and drug sensitivity test were carried out for patients in infection group and non infection group respectively,and the results were studied retrospectively.Results(1)There was no significant difference in demographic information,gender,age,basic diseases(hypertension,diabetes,etc.)and disease severity between infection group and non infection group(P>0.05),there were significant differences in ESR,Liver function between the infection group and the non infection group(P<0.05).(2)The positive rate of microorganisms cultured in bile of 241 patients in the infection group was73.03%(176/241),gram-negative bacteria accounted for 60.46%,gram-positive bacteria accounted for 37.64%,fungi accounted for 1.90%.The positive rate of microorganisms cultured in bile of 80 patients in non infection group was 56.25%,gram-negative bacteria accounted for 50.00%,gram-positive bacteria accounted for 47.83%and fungi accounted for 2.17%.(3)Carbapenem resistant bacteria accounted for 17.11%(45/263)of Gram-negative bacteria in the infection group and 21.74%(10/46)of patients in the non infection group,which was not statistically significant(X~2=0.573,P=0.449),The proportion of carbapenem resistant Escherichia coli and carbapenem resistant klebsiella pneumoniae in the corresponding strains cultured in the two groups was 30.77%,60.00%,60.00%and 60.00%.(4)The positive detection rate was higher in patients over 60 years old,with fever and a history of biliary tract diseases(P<0.05).Conclusion(1)Gram negative bacteria are the main microorganisms with acute obstructive cholangitis,followed by gram-positive bacteria and fungi.The pathogenic bacteria of biliary tract infection are escherichia coli,enterococcus and klebsiella pneumoniae.(2)The drug sensitivity of bile microbial pathogens to antibiotics in patients with acute obstructive cholangitis is serious,especially gram-negative bacteria.(3)The positive detection rate was higher in patients over 60 years old,with fever and a history of biliary tract diseases.