老年导管伴随性尿路感染菌群分布及耐药性分析  

Pathogenic Bacteria in Elderly with Catheter-associated Urinary Tract Infections:Analysis of Distribution and Antibiotic Resistance

作　　者：徐卫刚[1] 浦裕美[1] 裴彬[1] 沈瑜[1] 

机构地区：[1]上海市皮肤病性病医院内科,上海200443

出　　处：《中华医院感染学杂志》2010年第14期2171-2173,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年导管伴随性尿路感染常见病原菌及其耐药状况。方法 529例老年尿路感染患者按照有无留置导尿分为导尿组和对照组,分析中段尿培养结果。结果导尿组清洁中段尿细菌检出率高于对照组;导尿组病原菌的构成不同于对照组,导尿组尿路感染病原菌占前3位的是:大肠埃希菌35.9%,铜绿假单胞菌16.6%,奇异变形菌11.6%;对照组尿路感染病原菌占前3位的是:大肠埃希菌42.4%,奇异变形菌22.4%,肺炎克雷伯菌12.9%;导尿组产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率显著高于对照组;导尿组革兰阴性杆菌及大肠埃希菌多种抗菌药物的耐药性高于对照组,头孢哌酮/舒巴坦是仅次于碳青酶烯类外最敏感的抗菌药物。结论老年导管伴随性尿路感染菌群构成不同于普通老年尿路感染,其感染病原菌耐药性高,头孢哌酮/舒巴坦是此类尿路感染较为理想的选择。OBJECTIVE To analyze the distribution and antibiotic resistance of pathogenic bacteria in elderly with Catheter-associated urinary tract infections（UTIc）.METHODS Totally 529 patients were randomized into two groups,the trial group was with the catheterized patients and the control group was with the non-catheterized patients.The results of cultivating of their clean middle urine samples were analized.RESULTS The cultivating rate of clean middle urine in trial group was higher than the control group.The constituent ratios of bacteria in trial group was different from the control group.The three most commonly encountered pathogens in trial group were Escherichia coli（35.9%）,Pseudomonas aeruginosa（16.6%）,and Proteus mirabilis（11.6%）,vs E.coli（42.4%）,P.mirabilis（22.4%）,and Klebsiella spp（12.9%） in control group.ESBLs isolates from E.coli and Klebsiella spp in trial group were significantly higher than the control group.The ressitance rate of Gram-negative bacilli and E.coli in trial group were higher than that of control group.Cefoperazone/sulbactam was one of the most sensitive antibiotics after carbapenems.CONCLUSIONS The constituent ratios of bacteria in the elderly with UTIc are different from that with commonUTI.The antibiotic resistance is higher and Cefoperazone/sulbactam is an ideal choice.

关 键 词：导管伴随性尿路感染 耐药性 老年患者 病原菌 超广谱Β-内酰胺酶 

分 类 号：R378[医药卫生—病原生物学]