前列腺增生症患者尿路感染病原菌与耐药性分析  

Distribution and drug resistance of pathogens causing urinary tract infections in patients with hyperplasia of prostate

作　　者：黄金明[1] 郭建功[1] 任宏伟[1] 方晓[1] 郝丹[1] 

机构地区：[1]南阳医学高等专科学校第一附属医院泌尿外科,河南南阳473058

出　　处：《中华医院感染学杂志》2016年第9期2108-2110,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(U1301227)

摘　　要：目的研究前列腺增生症患者尿路感染病原菌分布及耐药性,为临床合理用药提供参考。方法选择2011年2月-2015年9月于医院住院治疗的208例前列腺增生尿路感染患者为研究对象,分析患者感染病原菌分布及耐药性;采用SPSS17.0软件进行统计分析。结果共分离出病原菌242株,其中革兰阴性菌165株占68.18%,革兰阳性菌77株占31.82%;前4位病原菌依次为大肠埃希菌、屎肠球菌、粪肠球菌、肺炎克雷伯菌,分别占49.17%、11.57%、9.92%、8.68%;产超广谱β-内酰胺酶(ESBLs)大肠埃希菌对哌拉西林、头孢呋辛、头孢他啶、头孢曲松、氨曲南和左氧氟沙星等药物的耐药性显著高于非产ESBLs菌;产ESBLs肺炎克雷伯菌对哌拉西林、头孢西丁、氨曲南、左氧氟沙星和磺胺甲噁唑/甲氧苄啶等药物的耐药性显著高于非产ESBLs菌,差异有统计学意义(P<0.05);屎肠球菌对庆大霉素、青霉素及红霉素的耐药率分别为89.29%、85.71%及82.14%,粪肠球菌对庆大霉素及氯霉素的耐药率分别为91.67%及62.50%。结论前列腺增生尿路感染者的大肠埃希菌、肺炎克雷伯菌及肠球菌属等病原菌存在较高的耐药率,在临床治疗时需综合尿培养及药敏试验结果,合理选择抗菌药物进行治疗。OBJECTIVE To explore the distribution and drug resistance of pathogens causing urinary tract infections in patients with hyperplasia of prostate so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 208 prostatic hyperplasia patients with urinary tract infections who were hospitalized from Feb 2011 to Sep 2015 were recruited as the study objects,then the distribution and drug resistance of the pathogens causing infections were observed,and the statistical analysis was performed with the use of SPSS17.0software.RESULTS Totally 242 strains of pathogens were isolated,including 165（68.18%）strains of gram-negative bacteria and 77（31.82%）strains of gram-positive bacteria.Escherichia coli,Enterococcus faecium,Enterococcus faecalis,and Klebsiella pneumoniae ranked the top 4species of pathogens,accounting for 49.17%,11.57%,9.92%,and 8.68%,respectively.The drug resistance rates of the extended-spectrumβ-lactamases（ESBLs）-producing E.coli to piperacillin,cefuroxime,ceftazidime,ceftriaxone,aztroenam,and levofloxacin were significantly higher than those of the non-ESBLs-producing strains.The drug resistance rates of the ESBLs-producing K.pneumoniae to piperacillin,cefoxitin,aztreonam,levofloxacin,and sulfamethoxazole-trimethoprim were significantly higher than those of the non-ESBLs-producing strains（P〈0.05）.The drug resistance rates of E.faeciumto gentamicin,penicillin,and erythromycin were 89.29%,85.71%,and 82.14%,respectively;the drug resistance rates of E.faecalis to gentamicin and chloramphenicol were 91.67% and 62.50%,respectively.CONCLUSION The pathogens causing urinary tract infections in the patients with hyperplasia of prostate,including E.coli,K.pneumoniae,and Enterococcus spp,are highly drug-resistant.It is necessary for the hospital to reasonably use antibiotics based on the results of urine culture and drug susceptibility testing.

关 键 词：前列腺增生症 尿路感染 病原菌 耐药性 

分 类 号：R697.3[医药卫生—泌尿科学]