Abstract:

Objective To provide a reference for the clinical diagnosis and treatment of biliary infection resulting from Acinetobacter baumannii after liver transplantation by distinguishing the constituent ratio and resistance phenotype of Acinetobacter baumannii from biliary culture results and drug-resistance test collecting from liver transplant recipients. Methods The results of biliary culture and drug resistance test of 1950 biliary specimens were collected retrospectively from patients who received liver transplantation during January 2009 and September 2013. Constituent ratio and resistance phenotype of Acinetobacter baumannii in pathogen positive specimens were analyzed. Results In 1 950 biliary specimens, 1 348 biliary specimens were turned out to be pathogen positive, a total of 1436 strains of pathogenic microorganism were detected, including 777 strains of Gram—negative bacteria. 82 strains of Acinetobacter baumannii were identified, the constituent ratio was 10.55%(82/777), total ratio was 5.71%(82/1436). There were 12, 21, 19, 22, 8 strains of Acinetobacter baumannii each year respectively, and correspondingly the constituent ratio was 9.38%, 10.50%, 11.24%, 17.32% and 5.34%. Drug resistant test showed that Acinetobacter baumannii in biliary specimens were resistant to most antibiotics frequently used in clinic except for colistin. Conclusion The detection and constituent ratio of Acinetobacter baumannii in biliary specimens of livertransplant recipients is increasing and the majority of them have a high resistance rate to most antibiotics frequendy used in clinic except for colistin.

Key words:

Liver transplantation , Biliary infection , Acinetobacter baumannii , Drug resistence

摘要：

目的通过分析肝移植受者胆汁培养结果和药敏结果中鲍曼不动杆菌的构成比和耐药性情 况，为临床上肝移植术后胆道鲍曼不动杆菌感染的诊断和治疗提供参考。方法 回顾性分析2009年]月至 2013年9月天津市第一中心医院肝移植科送检的1950份移植受者胆汁培养结果和药敏结果，对其中鲍曼 不动杆菌的构成比和耐药性进行分析。结果1950胆汁标本中，共有1348份胆汁标本检出阳性病原菌菌 株1436株，其中革兰阴性菌777株，有鲍曼不动杆菌82株，构成比为10.55% ( 82/777)，总构成比为5.71(82/1436);各年份依次检出鲍曼不动杆菌12株、21株、19株、22株和8株，在同期检出的革兰阴性菌中 的构成比分别是9.38%、10.50%、11.24%、17.32%和5.34% ;药敏结果显示鲍曼不动杆菌对除黏菌素以外 的多种抗菌药物耐药率高，耐药范围广。结论肝移植受者胆汁标本中鲍曼不动杆菌的检岀株数和构成比 正处于上升态势，所检出的菌株对除黏菌素以外的多种抗菌药物耐药率高，耐药范围广。

关键词: 肝移植, 胆道感染, 鲍曼不动杆菌, 耐药性