创伤性尿道狭窄患者感染病原菌分布与药敏分析  

Distribution and drug susceptibility of pathogens causing infections in patients with traumatic urethral strictures

作　　者：李贵忠[1] 满立波[1] 黄广林[1] 

机构地区：[1]北京积水潭医院泌尿外科,北京100035

出　　处：《中华医院感染学杂志》2015年第13期2959-2961,共3页Chinese Journal of Nosocomiology

基　　金：北京市"十百千"卫生人才专项基金资助项目(京卫人字[2010]18)

摘　　要：目的了解尿道狭窄患者的病原菌分布及其耐药性,为尿道狭窄患者术后抗菌药物应用提供临床依据。方法分析2012年1月-2013年4月在医院行尿道狭窄治疗48例患者的临床资料,所有患者术前行血液、尿液常规检查及尿液病原菌培养,对阳性结果进行菌种鉴定和敏感性检测。结果尿道狭窄患者48例,尿培养阳性29例,阳性率60.4%;共培养出17种44株病原菌,革兰阴性杆菌、革兰阳性球菌和真菌各28、14和2株,分别占63.6%、31.8%和4.6%;革兰阴性杆菌对阿米卡星、亚胺培南和美罗培南的敏感率为100.0%;革兰阳性球菌对呋喃妥因、万古霉素和利福平等药物敏感,而对克林霉素、红霉素、环丙沙星、青霉素和磺胺甲噁唑/甲氧苄啶普遍耐药。结论创伤性尿道狭窄患者菌种分布以革兰阴性杆菌为主,对不同抗菌药物的敏感率差异较大,术前应根据药敏结果用药。OBJECTIVE To understand the distribution and drug resistance of the pathogens isolated from the pa‐tients with urethral strictures so as to provide guidance for postoperative use of antibiotics .METHODS The clinical data of 48 urethral strictures patients who were treated in the hospital from Jan 2012 to Apr 2013 were analyzed , then the blood ,urine routine examinations and the culture of urine were performed for all the patients before the surgery ,the pathogens cultured positive were identified ,and the drug susceptibility testing of the pathogens was performed .RESULTS The urine specimens were cultured positive in 29 of 48 patients with urethral strictures ,with the positive rate of 60 .4% .A total of 44 （17 species） strains of pathogens have been isolated ,including 28 （63 .6% ） strains of gram‐negative bacilli ,14 （31 .8% ） strains of gram‐positive cocci ,and 2 （4 .6% ） strains of fungi .The drug susceptibility rates of the gram‐negative bacilli to amikacin ,imipenem ,and meropene were 100 .0% ;the gram‐positive cocci were susceptible to nitrofurantoin ,vancomycin ,and rifampicin ,but were gener‐ally resistant to clindamycin , erythromycin , ciprofloxacin , penicillin , and sulfamethoxazole‐trimethoprim . CONCLUSION The gram‐negative bacilli are dominant among the pathogens isolated from the patients with trau‐matic urethral strictures and vary significantly in the drug susceptibility rate .The preoperative medication should be performed based on the results of the drug susceptibility testing .

关 键 词：尿道狭窄 感染 药敏试验 尿培养 病原菌 

分 类 号：R378[医药卫生—病原生物学]