尿路感染患者细菌培养和药敏试验分析及临床意义探讨  

Analysis and study of germiculture and drug sensitive test in patients with urinary tract infection

作　　者：梁少群[1] 吴兴柳[1] 赵明聪[1] 丁佩佩[1] 吴贺明[1] 王海清[1] 陈克强[1] 孙明[1] 

机构地区：[1]广东省江门市中心医院,广东江门529070

出　　处：《中国民康医学》2013年第10期3-4,共2页Medical Journal of Chinese People’s Health

摘　　要：目的:分析尿路感染患者细菌谱的分布、药敏试验和耐药性等特点,以期为指导临床有效治疗和预防尿路感染提供依据。方法:对158例患者中段尿或尿路脓液行细菌培养后的病原体构成比例、分布特点、药物敏感试验结果特点、细菌耐药性状况等进行统计分析,寻求尿路感染细菌谱的构成情况和敏感药物现状。结果:尿路感染菌株以大肠埃希菌为主,占46.8%;其次为肠球菌属、肺炎克雷伯菌、铜绿假单胞菌,常见菌株还有葡萄球菌、念珠菌、链球菌、变形杆菌等。肠杆菌科细菌对亚胺培南、哌拉西林舒巴坦、庆大霉素等敏感性较高,而对左氧氟沙星、头孢曲松等耐药性较高。革兰阳性球菌对亚胺培南、哌拉西林舒巴坦、氨曲南等敏感性较高,对头孢噻肟、氨苄西林的耐药性较高。肾脏积脓或尿液絮状物患者的脓尿普通培养结果细菌阳性率相对较低。结论:尿路感染菌株仍以大肠埃希菌为主,治疗和预防应选择哌拉西林舒巴坦等敏感率相对较高的药物。留置尿管患者真菌感染和铜绿假单胞菌感染率较高,及时更换尿管可有效减少和预防尿管并发感染。糖尿病患者更容易出现产气肠杆菌类所致尿路感染,容易出现肾周脓肿和感染性休克。Objective：To analyze the distribution characteristics of the bacterial spectrum,susceptibility testing and drug resistance in patients with urinary tract infection ,in order to provide the reference for the clinical effective treatment and prevention of urinary tract infection. Methods： 158 pa-tients of pathogen constituent ratio,distribution characteristics, drug sensitivity testand bacterial drug resistance were analyzed, sought the composition of u-rinary tract infection bacteria spectrum and status of sensitive drugs. Results：Escherichia coli was the commonest in urinary tract infection （46.8%）, the other common bacteria were enterococcus, klebsiella pneumoniae, pseudomonas aeruginosa, staphylococci, candida and bacillus proteus. Drug sensitivity of imipenem, piperacillin and sulbactam and gentamicin were high for enterobacteriaceae, but levofloxacin and ceftriaxone were low. Drug sensitivity of imi- penem, piperacillin and sulbactam, aztreonam were high for gram positive coccus, but cefotaxim and ampicillin were low. Conclusion： Escherichia coli is the commonest in urinary tract infection,piperacillin and sulbactam should be preferred for urinary tract infection. Pseudomonas aeruginosa and candida were commonest in patients with indwelling catheter. Enterobacter aerogenes was commonest in patients with diabetic.

关 键 词：尿路感染 细菌培养 药敏试验 

分 类 号：R691.3[医药卫生—泌尿科学]