原发性肾病综合征患者尿路感染特征与病原菌耐药性分析  

Characteristics of urinary tract infections in patients with primary nephrotic syndrome and drug resistance of pathogens

作　　者：王春花[1] 王正红 滕燕民[1] 刘海霞[1] 秦兰芳 

机构地区：[1]青海省人民医院肾内科,青海西宁810000

出　　处：《中华医院感染学杂志》2017年第22期5126-5128,5159,共4页Chinese Journal of Nosocomiology

基　　金：青海省科学技术厅科技计划基金资助项目(2014-ZJ-747)

摘　　要：目的探讨原发性肾病综合征(PNS)患者尿路感染的临床特征、病原菌分布及耐药性。方法选取医院2014年4月-2017年4月收治的375例PNS,根据是否发生尿路感染分为感染组和非感染组,分析感染患者病原菌分布及耐药性,以及发生感染的临床特征。结果 375例PNS患者共发生67例尿路感染,感染率17.87%;共分离83株病原菌,其中革兰阴性菌67株,占80.72%,革兰阳性菌11株,占13.25%,真菌5株,占6.03%;大肠埃希菌对氨苄西林耐药率最高为82.86%,对亚胺培南耐药率最低为5.71%;肺炎克雷伯菌对氨苄西林耐药率最高为75.00%,对亚胺培南耐药率最低;表皮葡萄球菌对庆大霉素的耐药率最高为100.00%,对左氧氟沙星和头孢哌酮耐药性最低为0;感染组患者的24h尿蛋白定量、尿素氮、血肌酐明显高于非感染组,住院时间长于非感染组,而血清白蛋白及IgG水平明显低于非感染组。结论应根据感染的临床特征及病原菌耐药性,合理选择抗菌药物。OBJECTIVE To explore the clinical characteristics of urinary tract infections in patients with primary ne-phrotic syndrome（PNS）and observe the distribution and drug resistance of pathogens.METHODS A total of 375 patients with PNS who were treated in the hospital from Apr 2014 and Apr 2017 were enrolled in the study and di-vided into the infection group and the non-infection group according to the status of occurrence of urinary tract in-fections,the distribution and drug resistance of pathogens causing the infections were analyzed,and the clinical characteristics of the infections were observed.RESULTS Of the 375 patients with PNS,totally 67 had urinary tract infections,with the infection rate 17.87%.A total of 83 strains of pathogens were isolated,of which 67 （80.72%）were gram-negative bacteria,11（13.25%）were gram-positive bacteria,and 5（6.03%）were fungi. The drug resistance rate of Escherichia coli strains to ampicillin was the highest（82.86%）,the drug resistance rate to imipenem was the lowest（5.71%）;the drug resistance rate of K lebsiella pneumoniae strains to ampicillin was highest（75.00%）,and the drug resistance rate to imipenem was the lowest;the drug resistance rate of Staphylococcus epidermidis strains to gentamicin was the highest（100.00%）,the drug resistance rates to levo-floxacin and cefoperazone were the lowest（0%）.The levels of 24h urine protein quantification,urine nitrogen and serum creatinine of the infection group were remarkably higher than those of the non-infection group,the length of hospital stay of the infection group was longer than that of the non-infection group,however,the levels of serum albumin and IgG of the infection group were significantly lower than those of the non-infection group. CONCLUSION It is necessary to reasonably use antibiotics based on the clinical characteristics of the infections and the drug resistance of pathogens.

关 键 词：原发性肾病综合征 尿路感染 病原菌 耐药性 临床特征 

分 类 号：R691.3[医药卫生—泌尿科学]