121例慢性细菌性前列腺炎病原菌检测及耐药谱分析  

Identification and drug resistance analysis of pathogenic bacteria in 121 patients with chronic bacterial prostatitis

作　　者：苏运钦[1] 刘菊珍[1] 李菊香[1] 谢庆芳[1] 尹更生[1] 

机构地区：[1]暨南大学附属第一医院临床检验中心,广东广州510632

出　　处：《中国病理生理杂志》2012年第5期941-943,共3页Chinese Journal of Pathophysiology

基　　金：广东省医学科研基金资助项目(No.A2008341)

摘　　要：目的:了解引起我院慢性细菌性前列腺炎的病原菌分布及其耐药谱特征,为临床诊断和治疗细菌性前列腺炎提供依据。方法:用无菌方法采集前列腺炎患者的前列腺液进行细菌培养,利用VITEK2 Compact生物鉴定系统对细菌培养阳性的菌株进行种属鉴定,参照美国临床和实验室标准协会(CLSI)推荐的方法,采用K-B法进行体外药敏试验,用WHONET 5.6软件分析病原菌的耐药谱特征。结果:121例细菌性前列腺炎患者中,革兰阳性细菌感染患者93例(76.8%),革兰阴性细菌28例(23.2%),其中分离率前3位的细菌分别是金黄色葡萄球菌(29例,23.9%)、溶血性葡萄球菌(23例,19.0%)和表皮葡萄球菌(18例,14.9%)。药敏试验结果显示,3种主要革兰阳性细菌对万古霉素、替考拉宁和利奈唑胺全部敏感,对庆大霉素、红霉素、克林霉素、头孢西丁、苯唑西林和环丙沙星存在不同程度的耐药(7.1%～78.4%),对青霉素的耐药率高达90%以上;大肠埃希菌对亚胺培南、美罗培南和厄他培南全部敏感,对头孢噻肟、头孢曲松、环丙沙星、四环素、复方新诺明等抗生素有不同程度的耐药(14.5%～69.7%)。结论:我院慢性细菌性前列腺炎患者的病原菌主要是金黄色葡萄球菌、溶血性葡萄球菌、表皮葡萄球菌和大肠埃希菌。慢性细菌性前列腺炎患者的治疗应以药敏试验结果为依据,合理选用抗菌药物。AIM： To investigate the distribution and the antimicrobial resistance of the pathogenic bacteria from chronic bacterial prostatitis. METHODS： Prostatic fluid was collected under sterile condition and was inoculated for bacterial culture. Positive results of bacterial culture were identified by VITEK 2 Compact. Drug sensitivity test was carried out with K - B method according to the recommendation of Clinical and Laboratory Standards Institute （CLSI）. WHONET 5.6 software was used to analyze the results of drug resistance. RESULTS： Bacteria were identified in 121 patients with chronic prostatitis, most of which were Staphylococcus aureus （29 strains, 23.9% ）, Staphylococcus haemolyticus （23 strains, 19.0% ） and Staphylococcus epidermidis （18 strains, 14.9% ）. There were 93 strains of Gram -positive bacteria （76.8%）, and Gram- negative bacteria were 28 strains （23.2%）. The results of drug sensitivity test indicated that Staphylococcus aureus, Staphylococcus haemolyticus and Staphylococcus epidermidis were susceptible to vancomycin, teicoplanin and linezolid, while they were resistant to gentamicin, erythromycin, clindamycin, cefoxitin, oxacillin and ciprofloxacin with the resistant rates from 7.1% to 78.4%. Escherichia coli were susceptible to imipenem, meropenem and ertapenem, while they were resistant to cefotaxime, ceftriaxone, ciprofloxacin, tetracycline and trimethoprim - sulfamethoxazole with different resistant rates （ 14.5% - 69.7% ）. CONCLUSION： The major pathogenic profile of chronic bacterial pros- tatitis was Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus epidermidis and Escherichia coli. Drugs should be appropriately used on chronic bacterial prostatitis patients base on the results of culture and drug sensitivity test.

关 键 词：慢性细菌性前列腺炎 病原菌 耐药 

分 类 号：R69[医药卫生—泌尿科学]