兰州大学学报（医学版）2026，Vol.52Issue(3)：44-48,66,6.DOI:10.13885/j.issn.2097-681X.M20250301
结石性胆囊炎胆汁厌氧菌感染特征与术后抗生素应用研究
Anaerobic bacteriological profile in bile of calculous cholecystitis patients and its implications for postoperative antibiotic stewardship
摘要
Abstract
Objective To analyze the infection characteristics of pathogenic bacteria in the bile of patients with acute and chronic calculous cholecystitis,providing scientific guidance for rational antibiotic use.Methods A total of 356 patients with acute or chronic calculous cholecystitis undergoing laparoscopic cholecystectomy at The Second Hospital of Lanzhou University(January 2017-January 2024)were enrolled.Intraoperatively,bile samples were aseptically collected and subjected to parallel anaerobic and aerobic cultures to comprehensively analyze the distribution of pathogenic bacteria and establish a biliary pathogen profile.Results Anaerobic culture:no growth 146(41.0%);Staphylococcus epidermidis 50(14.0%);Escherichia co-li 40(11.2%);Streptococcus viridans 24(6.7%);Enterococcus faecalis 20(5.4%);Staphylococcus hominis 20(5.4%);Enterococcus faecium 12(3.6%);Staphylococcus aureus 12(3.6%);Micrococcus spp.10(2.7%);Klebsiella pneumoniae 6(1.7%);Haemophilus parainfluenzae,Enterobacter cloacae,Staphylococcus haemo-lyticus 4 each(0.9%);Staphylococcus warneri,Bacillus pumilus,Acinetobacter junii,Staphylococcus capitis 2 each(0.6%).Aerobic culture no growth:254(71.3%);S.epidermidis 30(8.4%);E.faecalis 18(5.1%);E.coli 16(4.5%);S.hominis 16(4.5%);S.capitis,S.aureus,E.cloacae 2 each(0.6%).Bacterial distribution did not differ significantly between acute and chronic cholecystitis(P>0.05).Patients with bacteria-positive bile had a larger gallstone diameter(P=0.0016),greater stone number(P=0.003),and thicker gallbladder wall(P<0.001).Conclusion In patients with acute and chronic calculous cholecystitis with positive bile cultures,an-aerobic bacteria predominate.It is therefore recommended that clinicians judiciously consider the strategy for prophylactic antibiotic use following laparoscopic cholecystectomy,avoiding unnecessary antimicrobial therapy to improve patient outcomes.关键词
急慢性结石性胆囊炎/胆汁培养/病原菌/细菌分布/抗菌药物预防/厌氧菌/胆囊切除术Key words
acute and chronic calculous cholecystitis/bile culture/pathogenic bacteria/bacterial distribution/antimicrobial prophylaxis/anaerobic bacteria/cholecystectomy分类
医药卫生引用本文复制引用
崔鸿斌,史树勋,马斌,李海元,韩晓雯,陈昊..结石性胆囊炎胆汁厌氧菌感染特征与术后抗生素应用研究[J].兰州大学学报（医学版）,2026,52(3):44-48,66,6.基金项目
国家自然科学基金资助项目(82473266,82160129) （82473266,82160129）
甘肃省卫生健康行业科技创新重大科研资助项目(GSWSZD-2024-17) （GSWSZD-2024-17）
甘肃省联合科研基金一般项目(24JRRA929) （24JRRA929）
甘肃省科技重大专项资助项目(22ZD6FA054) （22ZD6FA054）
甘肃省重点人才资助项目(2019RCXM020) （2019RCXM020）
兰州市城关区科技计划资助项目(2020SHFZ0039) （2020SHFZ0039）
兰州大学第二医院"萃英科技创新"计划资助项目(CY2023-ZD-01) （CY2023-ZD-01）
