脊髓损伤患者泌尿系感染病原菌分布与耐药性分析  

The bacteria distribution and drug resistance in urinary tract infection of patients with spinal cord injury

作　　者：张彦丽[1] 李卫红[2] 陈惠[3] 陈爽[2] 刘桂芬[2] 

机构地区：[1]首都医科大学康复医学院北京博爱医院中西医结合康复科,北京100068 [2]首都医科大学康复医学院北京博爱医院病案室,北京100068 [3]首都医科大学康复医学院北京博爱医院检验科,北京100068

出　　处：《中国医药导报》2009年第31期126-128,共3页China Medical Herald

摘　　要：目的:了解脊髓损伤患者泌尿系感染细菌分布及耐药状况。方法:对我院2008年间住院的脊髓损伤合并泌尿系感染患者的尿标本中的138株菌株进行分析。结果:脊髓损伤患者泌尿系感染患者主要致病革兰阴性杆菌是大肠埃希菌(68.2%)、奇异变形杆菌(10.0%)、肺炎克雷伯杆菌(6.4%);主要革兰阳性球菌是粪肠球菌(57.1%)、金黄色葡萄球菌(14.3%)、绿色气球菌(10.7%)。主要革兰阴性杆菌致病菌对二、三代头孢类抗生素和喹诺酮类耐药率增加,呈中高度耐药,而对含β-内酰胺酶抑制剂的复方制剂和氨基苷类较敏感。主要革兰阳性球菌对万古霉素均很敏感,而对大环内酯类和二代头孢呈中高度耐药。结论:脊髓损伤患者合并泌尿系感染,致病菌以革兰阴性杆菌为主,但是革兰阳性球菌有升高趋势。致病菌耐药菌株增加,临床应根据细菌培养和药敏实验结果,合理选择抗生素。Objective： To determine the bacteria distribution and drug resistance in urinary tract infection of patients with spinal cord injury. Methods： 138 pathogenic strains isolated from urine specimens of patients with spinal cord injury in 2008 were analyzed. Results： Among G- bacilli the main pathogenic germs were Escherichia coli （68.2%）, P.mirabilis （10.0%）, K.pneumoniae（6.4%）; among G＋ cocci were E.faeealis（57.1%）, Staphyloceocus aureus Rosenbaeh（14.3%）, Ae- rococcus viridans （10.7%）.The main G- bacilli were resistant to the second or third generation cephalosporins and quino- lones moderately or severely, but sensitive to [3-1actamase inhibitor combinations and aminoglycosides. The main G~ cocci were sensitive to vancomycin, but resistant to macrolides or the second generation cephalosporins moderately or severely. Conclusion： The main pathogenic bacteria in urinary tract infection of patients with spinal cord injury are G- bacilli, but G＋ cocci tends to increase. The bacteria resistant to antibiotics increases, antibiotics should be selected rationaly by urine culture and drug sensitivity test.

关 键 词：泌尿系感染 病原菌 耐药性 脊髓损伤 

分 类 号：R651.2[医药卫生—外科学]