61例重型颅脑创伤合并泌尿系感染的临床分析  

Clinical analysis of urinary tract infections in 61 patients with severe traumatic brain injury

作　　者：孙洪涛[1] 王延民[1] 涂悦[1] 程世翔[1] 张赛[1] 

机构地区：[1]武警后勤学院附属医院脑系科中心,天津300162

出　　处：《中华医院感染学杂志》2013年第6期1354-1355,共2页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(81271392);天津市应用基础及前沿技术研究计划项目(12JCYBJC18500);武警后勤学院院级项目(WYM201119)

摘　　要：目的探讨重型颅脑创伤(sTBI)伴泌尿系感染患者病原菌的构成比及耐药性,为临床用药提供依据。方法选取医院sTBI伴泌尿系统感染患者尿液进行病原菌的培养、鉴定,采用美国临床实验室标准化研究所推荐的K-B法进行药敏试验。结果 61株泌尿系统感染病原菌中,革兰阴性菌占63.9%,其中大肠埃希菌占39.3%,肺炎克雷伯菌占9.8%,革兰阳性菌占26.3%,真菌占9.8%;病原菌耐药性试验显示,肺炎克雷伯菌与大肠埃希菌除对亚胺培南/西司他丁无耐药,对哌拉西林/舒巴坦的耐药率<20.0%以外,对其他几种抗菌药物的耐药率均较高,屎肠球菌对万古霉素的耐药率为0。结论泌尿系统感染是颅脑创伤患者常见的并发症,临床医师要根据药敏试验指导用药,科学有效地控制感染。OBJECTIVE To study the constituent ratio and drug resistance of pathogens causing urinary tract infections in patients with severe traumatic brain injury （STBI） so as to provide basis for the clinical medication. METHODS The urine obtained from the patients with urinary tract infections complicated with STBI were cultured and identified, the drug susceptibility testing was performed by K 13 methods recommended by CLSI. RESULTS Among 61 strains of pathogens causing urinary tract infections, the gram-negatlve bacteria were the predominant pathogens and accounted for 63. 9%, among which Escherichia coli strains accounted for 39. 3~, Klebsiella pneumonia for 9.8% ; the gram-positive bacteria accounted for 26.3% ; the fungi accounted for 9.8%. The drug resistance test of the pathogens showed that the K. pneumoniae and E. coli strains were not resistant to imipenem/cilastatin, the drug resistance rates to piperacillin/sulbactam was lower than 20.0%, the drug resistance rates to other antibiotics were relatively high,and the drug resistance rate of Enterococcus faecium to vancomycin was 0%. CONCLUSION The urinary tract infection is common complication of the patients with traumatic brain injury; the clinician should use antibacterial agents according to the drug susceptibility testing so as to effectively control the infections.

关 键 词：泌尿感染 重型颅脑创伤 病原菌 

分 类 号：R181.32[医药卫生—流行病学]