统计行经皮肝穿刺胆道引流术（PTCD）治疗术后发生胆道感染患者胆汁中主要病原菌的分布情况，分析其对不同抗生素的敏感和耐药情况。

选取2014年6月至2016年6月在我院行PTCD术后发生胆道感染的患者219例，采集其胆汁样本进行细菌+真菌培养及药敏试验并分析。

（1）培养219例胆汁样本获得菌株数253株，含20个种类，其中革兰阴性菌194株（76.7%），革兰阳性菌53株（20.9%），真菌6株（2.4%）；革兰阴性菌前三位分别为大肠杆菌93株（36.7%）、肺炎克雷伯杆菌39株（15.4%）、铜绿假单胞菌18株（7.1%），革兰阳性菌排名前两位的分别为屎肠球菌17株（6.7%）、粪肠球菌14株（5.5%）；真菌以白色假丝酵母菌为主，共3株（1.2%）；（2）对革兰阴性菌敏感性较高的抗菌药物包括碳青霉烯类、氨基糖苷类及头孢类抗生素；对革兰阳性菌敏感性较高的抗菌药物包括喹诺酮类、恶唑烷酮类及糖苷类抗生素；真菌对三唑类抗真菌药物均保持敏感。

我院PTCD治疗术后胆道感染患者胆汁中的病原菌以革兰阴性菌为主，其次为革兰阳性菌和真菌，部分病例为混合性感染。

To investigate and analyze the distribution of main pathogenic bacteria in bile of patients with postoperative biliary infection after liver puncture percutaneous biliary drainage (PTCD) treatment and their sensitivity to different antibiotics.

The patients (219 cases) with biliary tract infection after PTCD treatment were collected in June 2014-June 2016, the bile samples were gathered, and bacteria+fungus culture and drug sensitive test were performed and analyzed.

(1) The 219 bile samples were collected, a total of 253 strains were obtained, containing 20 kinds and including 194 strains of G^- bacteria (76.7%) , 53 strains of G⁺ bacteria (20.9%) and 6 strains of fungus (2.4%) ; The top three G^- bacteria were Escherichia coli (93 strains, 36.7%) , Klebsiella pneumoniae (39 strains, 15.4%) and Pseudomonas aeruginosa (18 strains, 7.1%) . The top two G⁺ bacteria were Enterococcus faecium (17 strains, 6.7%) and Enterococcus faecalis (14 strains, 5.5%) ; The fungi were mainly Candida albicans (3 strains, 1.2%) . (2) Antibacterial drugs with high sensitivity to G^- bacteria included carbapenems, aminoglycosides and cephalosporins; Antibacterial drugs with high sensitivity to G⁺ bacteria included quinolones, oxazolanone and glycoside antibiotics. Fungi were sensitive to triazole antifungal drugs.

G^- bacteria are the main pathogenic bacteria in the bile of patients with biliary tract infection after PTCD treatment, followed by G⁺ bacteria and fungi, and some cases are mixed infection.