上尿路结石合并非特异性感染的细菌学研究  

Bacteriological Inspection for Complicating Nonspecific Infection of Upper Urinary Tract Calculi

作　　者：汪中扬[1] 马波[1] 潘兆君[2] 张泽[3] 瞿虎[1] 

机构地区：[1]中山大学附属第六医院泌尿外科,广东广州510655 [2]广州医学院第三附属医院泌尿外科广东广州 [3]广州医学院第一附属医院泌尿外科,广东广州

出　　处：《中山大学学报（医学科学版）》2009年第A04期263-266,274,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(05013924)

摘　　要：【目的】探讨上尿路结石合并非特异性感染的细菌学特点,了解常见致病菌的种类、菌谱特点、发生频率、对抗生素的耐药性和敏感性。以更好的指导临床治疗,减少抗生素的滥用。【方法】连续选取212例上尿路结石合并非特异性感染患者,通过经皮肾穿刺或输尿管导管留取肾盂尿液,进行尿细菌培养和药物敏感试验,统计细菌种类及其耐药谱。【结果】每份标本中均有细菌检出,212份标本共检出细菌223株,其中革兰阳性菌32.29%(72/223),革兰阴性菌60.01%(134/223),药敏试验结果不同于文献记载的细菌耐药谱,有明显差异。【结论】上尿路结石合并非特异性感染菌种分布广,不同菌种对抗生素的敏感性差异明显且不同于文献记载的细菌耐药谱,提示细菌培养和药敏试验在临床治疗中具有重要意义。[ Objective ] To study the bacterial category and distribution as well as its drug resistance and sensitivity of the complicating nonspecific infection of upper urinary tract calculi. [ Methods ] Two hundred and twelve patients who suffered from upper urinary tract calculi complicating nonspecific infection were consecutively selected for the study. Urine samples from the kidney pelvis were collected through percutaneous puncture of kidney or ureter tube for bacterial culture and drug sensitive test, the distribution and constitution of the pathogens and the drug resistance of the commonly use antibiotics were investigated. [ Results ] Positive result of bacterial culture was obtained for every urine sample, totally 223 strains bacterium were obtained, Gram-positive organism contributed to 32.29% （72/223） of the total bacteria and Gram-negative organisms 60.01% （134/223） respectively. The resistant rates of pathogens to the commonly used antimicrobials were higher than those of rarely used antimicrobial agents. Results of the drug sensitive test differed from the documented drug resistance spectrum. [Conclusion] Patients with upper urinary tract calculi have a higher incidence of Gram-negative bacterial infection, and the pathogen spectrum is diffused, drug sensitivity is quite differed for different strains. Our results suggest that bacterial culture and drug sensitive test is necessary for the treatment of upper urinary tract calculi complicating nonspecific infection.

关 键 词：上尿路结石 非特异性感染 治疗 细菌培养 药物敏感试验 

分 类 号：R714.56[医药卫生—妇产科学] R691.4[医药卫生—临床医学]