孕妇尿路感染病原菌分布及危险因素分析  

Distribution of pathogens causing urinary tract infections in pregnant women and risk factors

作　　者：曾华萍[1] 张世林[1] 罗文[2] 

机构地区：[1]南方医科大学附属佛山妇幼保健院综合住院部,广东佛山528000 [2]佛山市中医院内科,广东佛山528000

出　　处：《中华医院感染学杂志》2013年第21期5346-5347,5350,共3页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金指令性课题项目(C2013014)

摘　　要：目的探讨尿路感染孕妇中段尿培养的病原菌种类分布及危险因素,以达到预防孕妇尿路感染的目的。方法收集325例尿路感染孕妇为感染组,对其中段尿标本进行细菌培养,分析病原菌的种类和分布,同时选取未发生尿路感染的350例孕妇作为非感染组,调查两组的一般资料并采用logistic回归模型分析发生尿路感染的危险因素。结果共调查2361例孕妇中尿路感染325例,感染率为13.8%,共检出357株病原菌,其中革兰阴性菌175株占49.0%;革兰阳性菌163株占45.7%;真菌19株占5.3%;其中大肠埃希菌、金黄色葡萄球菌和表皮葡萄球菌的检出率居前3位,分别占64.0%、31.3%和21.5%;尿路感染的危险因素有年龄、贫血、流产史、妊娠期糖尿病、留置导尿管、泌尿系统疾病、膀胱冲洗、血清白蛋白和抗菌药物使用种类。结论尿路感染孕妇的主要病原菌为革兰阴性菌,且该类患者尿路感染的危险因素较多,应根据患者病情合理选择抗菌药物,同时进行及时地治疗。OBJECTIVE To explore the distribution of pathogenic bacteria cultured from midstream urine of pregnant women with urinary tract infections and analyze the risk factors so as to prevent the urinary tract infections in the pregnant women. METHODS A total of 325 pregnant women with urinary tract infections were set as the infection group, then the midstream urine specimens were sampled for the bacterial culture; meanwhile 350 pregnant women without urinary tract infections were assigned as the non-infection group; the general data of the two groups were investigated, and the risk factors for the urinary tract infections were analyzed with the use of logistic regression model. RESULTS Of totally 2361 pregnant women investigated, the urinary tract infections occurred in 325 cases with the incidence rate of 13.8%. Totally 357 strains of pathogens were detected, among which there were 175 （49.0% ） strains of gram-negative bacteria, 163 （45.7 % ） strains of gram-positive bacteria, and 19 （5. 3%） strains of fungi; the detection rates of Escherichia coli （64. 0%）, Staphylococcus aureus （31.3%）, and Staphylococcus epidermidis （21. 5%） ranked the top 3. The risk factors for the urinary tract infections included the age, anemia, history of abortion, gestational diabetes mellitus, catheter indwelling, urinary system disease, bladder irrigation, serum albumin , and type of used antibiotics. CONCLUSION The gramnegative bacteria are the main pathogens causing urinary tract infections in the pregnant women, there are many risk factors for the urinary tract infections; it is necessary to reasonably use antibiotics based on the patients condition and perform the timely treatment.

关 键 词：尿路感染 孕妇 中段尿培养 危险因素 

分 类 号：R378[医药卫生—病原生物学]