224例老年尿路感染菌群分布及临床耐药性分析  

A study of senile patients with urinary tract infection:The distribution of bacteria and drug tolerance analysis

作　　者：卢小军[1] 郑伟[1] 吴玉泉[1] 周春[1] 费明峰[1] 郑赟[1] 

机构地区：[1]解放军117医院干部病房,杭州310013

出　　处：《中华保健医学杂志》2011年第5期394-396,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的了解老年尿路感染患者的常见致病菌及其耐药性,为临床合理使用抗菌药物提供依据。方法收集本院近5年尿路感染的老年患者清洁中段尿细菌培养分离的224株致病菌,并对其进行耐药性监测。结果检出224株致病菌,其中革兰阴性菌153株(68.3%),革兰阳性菌48株(21.4%),真菌23株(10.3%)。革兰阴性菌中大肠埃希菌检出率最高为36.6%(82株),其次为肺炎克雷伯菌7.6%(17株),大肠埃希菌9.8%和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)17.6%。革兰阴性菌对哌拉西林、环丙沙星等耐药率较高,亚胺培南对革兰阴性菌的抗菌活性最强;革兰阳性菌中以肠球菌最多见,占11.2%(25株),革兰阳性菌对复方磺胺甲恶唑、红霉素的耐药率较高。结论老年患者尿路感染以革兰阴性菌为优势菌株,且耐药性日益严重,对亚胺培南最为敏感,革兰阳性菌对万古霉素敏感。Objective To guide the use of clinical drugs by studying the spctrum of pathogens isolated from urinary tract infection in senile patients and the drug resistance to antibiotics.Methods All the pathogens isolated from urine in senile patients from my hospital in last five years were studied.Bacterial susceptibility test was carried out by using Kirby-Baner method.Results Two hundred and twenty-four strains including 153 strains（68.3%）of Gram negative bacilli,48 strains（21.4%）of gram positive cocci,23 strains（10.3%）of fungi were collected.E.coli showed the highest detection rate of 36.6%（82）in gram-negative bacteria,followed by Klebsiella pneumonia with 7.6%（17）.E.coli.Klebsiella and Staphylococcus were the main microorganisms.9.8% of E.coli and 17.6% of Klebsiela were suspected to produce extended-spoctrum β-lactamase.The effective agents against gram negative organisms were imipenem,while the drug resistance rates of Gram negative bacilli to ciprofloxacin and piperacillin were above 49%.The drug resistance rate of gram positive cocci to SMZCO and erythromycin were above 40%,but the vancomycin resistant strain had not been found.Conclusions The drug resistance of bacteria in senile patients urinary tract infections is increasing.Gram negative bacilli is the main pathogen,and is susceptible to imipenem.Vancomycin is the first choice to treat infection with Gram positive cocci.

关 键 词：尿路感染 致病菌 耐药性 老年 

分 类 号：R691.3[医药卫生—泌尿科学]