Distributions of pathogenic bacteria and drug sensitivity in cholangitis after hepatico-portoenterostomy for biliary atresia / 实用医学杂志

ABSTRACT

Objective To explore the pathogenic bacterial distribution and drug sensitivity of cholangiitis in children who underwent hepatico-portoenterostomy for congenital biliary atresia in order to provide the guide for appropriate treatment. Methods The clinical data of 300 cases of congenital biliary atresia Kasai postoperative cholangitis in our hospital between 2007 and 2016 were included in the study to analyse the common pathogenic bacteria and antibiotics sensitivity according to its clinical types. Results(1)In the 300 children,cholangitis set on for 541 times,with blood culture positive in 128 cases.(2)The main pathogens of cholangitis after biliary atre-sia included escherichia coli,pseudomonas aeruginosa and enterococcus. Late cholangitis and frequent cholangitis contributed highly to enterococcus infections.(3)The sensitivity rates of escherichia coli and pseudomonas aerugi-nosa to cefoperazone sulbactam were 75% and 78%,respectively,and the rates to piperacillin tazobactam were 82% and 84%,respectively.The sensitivity rates to meropenem were 93% and 76%,respectively.The susceptibility of Enterococcus to vancomycin or linezolid was 100%.Conclusions Cefoperazone sulbactam and piperacillin tazo-bactam can be used as an option of antibiotics for biliary atresia Kasai postoperative cholangitis. In case of poor curative effect,timely replacement of meropenem is suggested.In case of late cholangitis and frequent cholangitis, enterococcus infection can be considered in its diagnosis.