根治性膀胱全切除并输尿管皮肤造口术后尿路感染病原菌及药敏分析  

The Bacteria Etiology and Susceptibility of the Patients with Urinary Tract Infection after the Operation of Radical Cystectomy and Ureterocutaneostomy

作　　者：张萌[1] 吴文霞[1] 蒋龙元[2] ZHANG Meng;WU Wen-xia;JIANG Long-yuan(Department of General Practice,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120;Department of Emergency,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou)

机构地区：[1]中山大学孙逸仙纪念医院全科医学科,510120 [2]中山大学孙逸仙纪念医院急诊科,510120

出　　处：《岭南急诊医学杂志》2018年第5期457-459,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨根治性膀胱全切除并输尿管皮肤造口术后尿路感染病原菌及药敏分析。方法:回顾性分析2013年6月至2017年12月在中山大学孙逸仙纪念医院行根治性膀胱全切并输尿管皮肤造口术58例的临床资料,追踪至术后半年,对其中18例发生尿路感染(部分合并血流感染)且再次住院治疗的患者留取尿液(发热病人同时抽取静脉血)送检病原学培养,分析其病原菌及其药敏。结果:18例尿培养均检出病原菌,其中8例发热患者同时在血液中检出相同病原菌。革兰氏阴性菌株14例,革兰氏阳性菌株6例,其中1例合并真菌。病原菌依次为大肠埃希菌、肺炎克雷伯和表皮葡萄球菌。药敏结果提示大部分病原菌对头孢哌酮、哌拉西林、氧氟沙星均耐药,对碳青霉烯类、替考拉宁敏感。结论:根治性膀胱全切并输尿管皮肤造口术后半年约31%并发尿路感染,其中44.4%同时合并血流感染。大多数病原菌只对碳青霉烯类和替考拉宁敏感。Objective： To explore the bacteria etiology and susceptibility of the patients with urinary tract infection after the operation of radical cystectomy and ureterocutaneostomy. Methods ： The clinical data of 58 cases received the operation of radical cystectomy and ureterocutaneostomy were analyzed retrospectively from jun. 2013 to Dec.2017. Then the cases were followed up for half a year. The urine （included blood sample if fever） were collected from 18 patients with urinary tract infection and rehospitalization, and then sent to the laboratory for etiology spectrum and sensitivity of microbial analysis. Results ： All the 18 eases were included, 8 out of these got fever and similar bacteria was checked out in blood sample as urine. 14 were Gram-negative rod and 6 were Gram-positive occurred, one was fungal infection. And the most frequently isolated bacteria were Escherichiacoli, Klebsiella pneumonia and Staphylococcus epiderrnidis. Sensitivity of microbial suggested that most of the bacteria were resistant to eephaloperazone sulbaetam, piperacillin and levofloxaein. But they were sensitive to earbapenem and teieoplanin. Conclusions： About 31% cases get urinary infection after radical cystectomy and ureteroeutaneostomy, 44% of which combined with blood stream infection. Most of the pathogenic bacteria are only sensitive to the carbapenem and teicoplanin.

关 键 词：根治性膀胱全切术 输尿管皮肤造口术 尿路感染 病原学 药敏 

分 类 号：R737.14[医药卫生—肿瘤]