L型菌慢性泌尿系感染诊断及抗生素运用  

Diagnosis of L model bacteria in chronic urinary tract infection and antibiotic use

作　　者：杨葵[1] 

机构地区：[1]四川省泸州医学院附属医院检验科,四川泸州646000

出　　处：《现代预防医学》2012年第15期3964-3965,3968,共3页Modern Preventive Medicine

摘　　要：目的探讨L型细菌在泌尿系的感染情况及其抗生素的耐药性,为临床诊治提供科学依据。方法用改良Kagan培养基(L型平板)对临床泌尿系感染者的尿液进行分离培养,并对所获得的L型细菌进行药物敏感试验。结果从128例患者的尿液标本中,检出L型伴细菌型感染率为82.8%(106/128),普通培养细菌检出率为66.4%(85/128)。其中,慢性泌尿系感染L型伴细菌型分离率93.8%(90/96),L型细菌分离率19.8%(19/96),共19株,细菌型分离率为74.0%(71/96)。结论对抗生素而言,耐药性最高的是青霉素类(青霉素G),其次依次为头孢菌素类(头孢三嗪、头孢唑啉、头孢噻肟)、氨基糖苷类(庆大霉素、阿米卡星、妥布霉素)和红霉素;而万古霉素、氯霉素、新生霉素呈低耐。临床对慢性泌尿系感染者应同时检测细菌及其L型,并根据药敏试验结果联合用药,以杀菌并阻止其变为L型。OBJECTIVE To explore L model bacteria in the urinary tract infection situation and the resistance to antibiotics, to provide scientific bases for clinical diagnosis and treatment. METHODS Used improved Kagan culture medium （L model flat） to separate and cultivate urine, which were from the clinical urinary tract infections patients. RESULTS From 128 patients＇ urine samples, we found that the detection rate of bacteria infection with L model bacteria was 82.8% （106/128）, and the rate of ordinary cultivating bacteria was 66.4% （85/128）. Among them, the separating rate of bacteria infection with L model bacte- ria in chronic urinary tract infection of patients was 93.8% （90/96）, the rate of L model bacteria was 19.8% （19/96）, and the rate of bacteria infection was 74.0% （71/96）. CONCLUSION The highest antibiotic resistance is in penicillin class （peni- cillin G）, the followed cephalosporin （ceftriaxone sodium, cefazolin, cefotaxime）, aminoglycoside （gentamicin, amikacin, tobramycin） and erythromycin; while vancomycin, chloromycetin and neomycina are with low antibiotic resistance. In chronic urinary tract infections, patients should also be detected bacteria and L model bacteria, and we should combine using drugs ac- cording to antimicrobial susceptibility test, to sterilize and prevent it from transforming to L model.

关 键 词：慢性泌尿系感染 L型细菌 抗生素 药物敏感性 

分 类 号：R691.3[医药卫生—泌尿科学]