[摘要] 目的：了解胆道疾病患者胆汁中细菌分布、药敏及抗菌药物应用是否合理。方法：收集2011年1月～2016年9月间本院普外科收治的289例患者胆汁标本细菌培养及药敏试验结果，结合这些患者的抗菌药物应用情况作回顾分析。结果：胆汁标本阳性检出率为39.5%，革兰阴性菌71.9%，革兰阳性菌为28.1%。居前6位的病原菌为大肠埃希菌（21.9%），肺炎克雷伯菌（13.3%），铜绿假单胞菌（10.1%），粪肠球菌（9.4%），阴沟肠杆菌（7.0%）。大肠埃希菌对大部分抗菌药物耐药率高。 粪肠球菌对万古霉素、利奈唑胺、青霉素G耐药率低。DDDs居前5位的抗菌药物是奥硝唑、头孢呋辛、头孢美唑、头孢吡肟、拉氧头孢。结论 抗菌药物应用不完全符合细菌耐药监测结果。临床应重视胆汁微生物检查，参照胆汁培养及药敏试验结果有针对性地选择抗菌药物。

[Abstract] Objective: To investigate the distribution and antibacterial susceptibility of bacterias in bile and antibacterial selection of patients with biliary tract diseases. Methods: The results of bacterial cultivation and drug-sensitivity tests of bile samples from 289 patients in general surgical ward in our hospital and these patients' consumption of antibacterials from January 2011 to September 2016 were collected and analyzed retrospectively. Results: The positive rate of tests was 39.5%. Gram-negative bacterias accounted for 71.9% and gram-positive bacterias accounted for 28.1%. The top 6 pathogens were Escherichia Coli (21.9%), Klebsiella Pneumoniae (13.3%), Pseudomonas Aeruginosa (10.1%), Enterococcus Faecalis (9.4%), Enterobacter Cloacae (7%). Escherichia coli had high rate of resistance to most antibacterials. Enterococcus faecalis had low rate of resistance to vancomycin, linezolid, and penicillin G. The top 5 antibacterials sorted by DDDs were ornidazole, cefuroxime, Cefmetazole, cefepime, latamoxef. Conclusion: The antibacterial seletion wasn't fully justified by the results of bacterial cultivation and drug-sensitivity tests. Doctors should think highly of microbiological examination of bile and select antibacterials according to the results.