中段尿细菌培养联合耐药性分析对复发性尿路感染抗菌药物合理使用的影响  

Effect of Combined Drug Resistance Analysis of Middle Urinary Bacterial Culture on Rational Use of Antibiotics in Recurrent Urinary Tract Infection

作　　者：王宇星[1] WANG Yu-xing(Department of Laboratory,Pingdingshan First People’s Hospital,Pingdingshan,Henan,467000,China)

机构地区：[1]平顶山市第一人民医院检验科,河南平顶山467000

出　　处：《黑龙江医学》2020年第7期884-886,共3页Heilongjiang Medical Journal

摘　　要：目的探究中段尿细菌培养联合耐药性分析对复发性尿路感染抗菌药物合理使用的影响。方法选取平顶山市第一人民医院2016年3月—2018年12月复发性尿路感染患者62例,进行中段尿培养分离,分离病原菌,进行耐药性分析。结果分离病原菌62株,其中革兰阴性菌43株,占69.35%;革兰阳性菌19株,占30.65%;前四位的病原菌为大肠埃希菌(29.03%)、肺炎克雷伯菌(16.13%)、粪肠球菌(14.52%)、屎肠球菌(9.68%);产超广谱β-内酰胺酶的肺炎克雷伯菌检出率为50.00%(5/10),大肠埃希菌检出率为61.11%(11/18),肺炎克雷伯菌对碳青霉烯类抗菌药物耐药率约10%,大肠埃希菌对碳青霉烯类抗菌药物耐药率<6%,肠杆菌科细菌对碳青霉烯类抗菌药物较敏感;鲍氏不动杆菌对碳青霉烯类抗菌药物的耐药率约50%,铜绿假单胞菌对碳青霉烯类抗菌药物的耐药率较低;屎肠球菌对氨苄西林、磺胺甲噁唑/甲氧苄啶、利福平、高浓度链霉素、环丙沙星、高浓度庆大霉素的耐药率较高;粪肠球菌对呋喃妥因、利奈唑胺、万古霉素、替加环素耐药率较低。结论复发性尿路感染患者中段尿细菌培养分离病原菌以革兰阴性菌为主,对病原菌分布特点、耐药性进行分析,对抗菌药物合理使用具有重要意义。Objective To investigate the effect of mid-stage urinary bacterial culture combined with drug resistance analysis on the rational use of antibiotics for recurrent urinary tract infections. Methods A total of 62 patients with recurrent urinary tract infection from March, 2016 to December, 2018 were enrolled in the hospital. The middle urine culture was isolated and the pathogens were isolated for drug resistance analysis. Results 62 strains of pathogens were isolated, including 43 Gram-negative bacteria,accounting for 69.35%;19 Gram-positive bacteria, accounting for 30.65%;the first four pathogens were Escherichia coli(29.03%),Klebsiella pneumoniae(16.13%), Enterococcus faecalis(14.52%) and Enterococcus faecium(9.68%);the detection rate of Klebsiella pneumoniae producing extended-spectrum β-lactamase was 50.00 %(5/10), the detection rate of Escherichia coli was 61.11%(11/18), the resistance rate of Klebsiella pneumoniae to carbapenems was about 10%, resistance rate of mycophenolic antibiotics was<6%, and the bacteria of Enterobacteriaceae were sensitive to carbapenems;the resistance rate of Acinetobacter baumannii to carbapenems was about 50%, and the patina was false. The resistance rate of monocytogenes to carbapenem antibiotics was low;E.coli on ampicillin, sulfamethoxazole/trimethoprim, rifampicin, high-concentration streptomycin, ciprofloxacin, high-dose gentamicin had a higher resistance rate;Enterococcus faecalis had a lower resistance rate to nitrofurantoin, linezolid, vancomycin and tigecycline. Conclusion The pathogens of urinary bacterial culture in patients with recurrent urinary tract infection are mainly Gram-negative bacteria. The distribution characteristics and drug resistance of pathogenic bacteria are analyzed, which is of great significance for the rational use of antibacterial drugs.

关 键 词：中段尿细菌培养 耐药性分析 复发性尿路感染 

分 类 号：R446.12[医药卫生—诊断学]