Distribution of pathogens, influencing factors and drug resistance in 453 positive bile culture patients with biliary tract infection

Objective To investigate distribution of pathogens, influencing factors and the characteristics of drug resistance.

Methods Distribution of pathogens and drug resistance in 453 positive bile culture patients with biliary tract infection were retrospectively analyzed. Patients'age, gender, diabetes, high blood pressure, heart disease, hyperlipidemia, history of biliary tract surgery, preoperative antibiotic use time as well as nature of the disease were collected, and their influences on distribution of pathogens were explored.

Results A total of 476 strains of pathogenic bacteria were isolated from 453 patients with positive bile culture. Among them, there were 380 strains(79.83%) of Gram-negative bacteria, 88 strains(18.49%) of Gram-positive bacteria, 8 strains(1.68%) of fungi. The main Gram-negative bacteria had higher resistance rates to ampicillin and cefazolin, and were more sensitive to piperacillin/tazobactam, carbapenems and gentamicin. The main Gram-positive bacteria had higher resistance rates to penicillin G, cefoxitin, gentamicin, tobramycin, amikacin, erythromycin, clindamycin, fucidic acid, rifampicin as well as trimethoprim, and were more sensitive to high concentration of gentamicin, glycosides, linezolid and quinupridine. The distribution of pathogenic bacteria was influenced by age, hypertension and preoperative antibiotic duration in patients with biliary tract infection.

Conclusion In positive bile culture patients with biliary tract infection, Gram-negative bacteria are the main pathogens. The distribution of pathogenic are associated with age, hypertension and preoperative use time of antibiotics. According to relevant influencing factors, rational and effective use of drugs in clinical treatment can be conducted. Afterwards, the treatment plans should be adjusted according to results of bacteriological test.