老年患者泌尿系统感染致病菌及其耐药性分析  

Pathogens and drug resistance study of urinary tract infection in elderly patients

作　　者：金立钢[1] 方芳[1] 陈允硕[1] 何银华[1] 缪亚兰[1] 

机构地区：[1]上海市市东医院检验科,上海200438

出　　处：《检验医学》2008年第3期227-229,共3页Laboratory Medicine

摘　　要：目的调查老年患者泌尿系统感染致病菌及其耐药性,为临床合理使用抗生素提供依据。方法对428例老年患者中段尿标本进行细菌培养及耐药性监测。结果共检测出病原菌435株,其中革兰阴性杆菌占61.8%,革兰阳性球菌占25.1%,真菌占10.3%;老年女性革兰阴性杆菌的感染率显著高于男性(P<0.01);革兰阴性及阳性细菌中分别以大肠埃希菌(39.1%)和肠球菌属(16.3%)最多。产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌对亚胺培南、哌拉西林-他唑巴坦、呋喃妥因、氨卞西林-舒巴坦、阿米卡星的耐药率低;肠球菌属细菌对万古霉素、利奈唑烷均100%敏感;葡萄球菌属细菌耐甲氧西林株达90.6%。结论老年患者泌尿系统感染以革兰阴性菌为优势菌株,细菌耐药性监测对指导临床合理用药具有重要意义。Objective To study pathogens ahd drug resistance of urinary tract infection in elderly patients, in order to choose right antibiotics for clinical treatment. Methods Bacterial culture and susceptibility test were carried out among 428 urine samples from elderly patients. Results Among 435 isolated strains, 61.8% gram negative bacilli, 25. 1%gram positive bacilli and 10.3% fungi were detected. The positive rate of gram negative bacillus in elderly female patients was significantly higher than that in male patients （P 〈 0.01 ）. Escherichia coli （39.1% ） and Enterococcus spp （ 16.3% ） were the most commom pathogens in gram negative bacilli and gram positive bacilli respectively. The effective agents against Escherichia coli producing extended spectrum β-lactamase （ESBLs） were imipenem, piperacilin- tazobactam, nitrofurantoin, ampicilin-sulbactam and amikacin. Vancomycin and linezolid showed 100% sensitive to Enterococcus spp. Methieillin resistant staphylococci strains were 90.6%. Conclusions Gram negative bacilli were the main pathogen for urinary tract infections in elderly patients. Bacterial susceptibility test showes important significance for clinical right antibiotics selection.

关 键 词：泌尿系统感染 致病菌 耐药性 老年 

分 类 号：R446.5[医药卫生—诊断学]