复杂性尿路感染女性中段尿病原菌培养及药敏试验结果分析  

Analysis of the results of pathogen culture and drug sensitivity test in the middle urinary tract of women with complicated urinary tract infection

作　　者：赵斌 王姣姣 ZHAO Bin;WANG Jiao-jiao(Department of Clinical Laboratory,Pingdingshan Hospital of Traditional Chinese Medicine,Pingdingshan 467099,China;Neurology of Department,The Second People's Hospital of Pingdingshan city,Pingdingshan 467092,China)

机构地区：[1]平顶山市中医医院检验科,河南平顶山467099 [2]平顶山市第二人民医院神经内科,河南平顶山467092

出　　处：《社区医学杂志》2021年第21期1307-1310,共4页Journal Of Community Medicine

摘　　要：目的探讨复杂性尿路感染女性中段尿病原菌分布特征及耐药性,以指导抗生素合理应用。方法选取2018-09-01-2020-05-31平顶山市中医医院接收的复杂性尿路感染患者210例为研究对象,患者均为女性。收集全部研究对象中段尿标本予以病原菌培养,采用WHO耐药性监测网的Whonet 5.4分析主要病原菌耐药性。结果210例患者中,合格率为34.76%(73/210),不合格率为65.24%(137/210)。73例合格标本中共分离病原菌202株,革兰氏阴性菌占67.16%(135/202)、革兰氏阳性菌占24.88%(50/202)、真菌占8.46%(17/202);肺炎克雷伯菌对妥布霉素、氨苄西林、头孢唑啉、头孢曲松、头孢他啶、左氧氟沙星、哌拉西林、环丙沙星耐药性高;铜绿假单胞菌对哌拉西林、丁胺卡那、环丙沙星耐药性高;大肠埃希菌对庆大霉素、氨苄西林、头孢唑啉、头孢曲松、头孢他啶、左氧氟沙星、哌拉西林、头孢哌酮/舒巴坦耐药性高;屎肠球菌对青霉素、红霉素、克林霉素、庆大霉素、四环素、头孢唑啉、呋喃妥因耐药性高;金黄色葡萄球菌对红霉素、克林霉素、氨苄西林、庆大霉素、四环素、头孢唑啉、环丙沙星、呋喃妥因耐药性高;粪肠球菌对红霉素、克林霉素、氨苄西林、庆大霉素、四环素、头孢唑啉、环丙沙星、呋喃妥因耐药性高;73例合格标本中显效48例,有效22例,无效3例,总有效率为95.89%(70/73)。结论复杂性尿路感染女性致病菌具有多样性,主要为革兰氏阴性菌,其次为革兰氏阳性菌,最后为真菌,且耐药性不同,应在病原菌培养与药敏试验结果指导下选择抗生素。Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria in female patients with complicated urinary tract infection in order to guide the rational use of antibiotics.Methods A total of 210 female patients with complex urinary tract infection received by Pingdingshan Hospital of Traditional Chinese Medicine from September 1,2018 to May 31,2018 were selected.Mid-stream urine samples of all subjects were collected for pathogen culture,and drug resistance of main pathogens was analyzed by Whonet 5.4 software of WHO drug resistance monitoring network.Results Of the 210 samples collected,73 were qualified,with a qualified rate of 34.76%(73/210),and 137 were unqualified,with a unqualified rate of 65.24%(137/210).A total of 202 strains of pathogenic bacteria were isolated from 73 qualified specimens,among which Gram-negative bacteria accounted for 67.16%(135/202),Gram-positive bacteria for 24.88%(50/202)and fungi for 8.46%(17/202).Klebsiella pneumoniae had high resistance to tobramycin,ampicillin,cefazoline,ceftriaxone,ceftazidime,levofloxacin,piperacillin,ciprofloxacin;Pseudomonas aeruginosa had high resistance to piperacillin,dimikana and ciprofloxacin.Escherichia coli had high resistance to genamicin,ampicillin,cefazolin,ceftriaxone,ceftazidime,levofloxacin,piperacillin,cefoperazone/sulbactam;Enterococcus faecium had high resistance to penicillin,erythromycin,clindamycin,gentamicin,tetracycline,cefazolin and furantoin.Staphylococcus aureus had high resistance to erythromycin,clindamycin,ampicillin,genamicin,tetracycline,cefazoline,ciprofloxacin and furantoin.Enterococcus faecalis had high resistance to erythromycin,clindamycin,ampicillin,genamicin,tetracycline,cefazoline,ciprofloxacin and furantoin.Among 73 qualified specimens,48 cases were significantly effective,22 cases were effective,and 3 cases were ineffective.The total effective rate was 95.89%(70/73).Conclusions The main pathogenic bacteria of female complicated urinary tract infection are gram-negative bacteria,fol

关 键 词：复杂性尿路感染 女性 中段尿标本 病原菌培养 药敏试验 抗生素合理使用 

分 类 号：R446.5[医药卫生—诊断学] R691.3[医药卫生—临床医学]