难治性UTI病原体耐药特点分析  

Drug resistance and clinical treatment of refractory UTI pathogens

作　　者：梁少群[1] 吴贺明[1] 罗铭 陈晓华[1] 赵明聪[1] 孙明[2] Liang Shaoqun;Wu Heming;Luo Min;Chen Xiaohua;Zhao Mingcong;Sun Ming(Department of Infection,Jiangmen Central Hospital,Affiliated Jiangmen Hospital of Sun Yat-sen University,Jiangmen,Guangdong 529070,China;Urinary Surgery,Jiangmen Central Hospital,Affiliated Jiangmen Hospital of Sun Yat-sen University,Jiangmen,Guangdong 529070,China)

机构地区：[1]广东省江门市中心医院感染科,广东江门529070 [2]广东省江门市中心医院泌尿外科,广东江门529070

出　　处：《医药前沿》2020年第20期22-23,共2页Journal of Frontiers of Medicine

摘　　要：目的:探讨临床复杂难治性泌尿系感染(UTI)患者病原体的耐药特点,寻求并优化选择临床治疗策略。方法:对本院门诊及住院反复感染或难治复杂的泌尿系感染患者尿液培养后的病原体耐药状况、分布特点、治疗效果等进行分析,探讨病因与病程规律,寻求有效实用的治疗选择方案。结果:难治泌尿系感染常见的病原体有大肠埃希菌、屎肠球菌、粪肠球菌、肺炎克雷伯菌等,对左氧氟沙星、头孢呋辛、氨苄西林等耐药性较高,对哌拉西林他唑巴坦、头孢哌酮舒巴坦的耐药性亦高,对亚胺培南等耐药性较低。结论:感染病程较短或治疗时间不长患者可先选择哌拉西林他唑巴坦、头孢哌酮舒巴坦等,对于病程迁延、反复发作、复杂难治性或感染严重的患者可选择亚胺培南等加强治疗。Objective To explore the drug resistance characteristics of pathogens in patients with complicated and refractory urinary tract infection,and to seek and optimize the clinical and practical treatment strategies.Methods We analyzed the drug resistance,distribution and therapeutic effect of pathogens after urine culture of outpatients and inpatients with recurrent infection or complicated urinary tract infection in our hospital,explored the etiology and course of disease,and sought effective and practical treatment options.Results The common pathogens of refractory urinary tract infection were Escherichia coli,Enterococcus faecium,Enterococcus faecalis,Klebsiella pneumoniae and so on.They were resistant to levofloxacin,cefuroxime,ampicillin,piperacillin tazobactam,cefoperazone sulbactam and imipenem.Conclusion The patients with short course of infection or short treatment time can choose piperacillin tazobactam,cefoperazone sulbactam.For patients with prolonged course,repeated attack,complex and refractory or severe infection,imipenem can be selected to strengthen the treatment.

关 键 词：泌尿系感染 耐药 治疗 

分 类 号：R691[医药卫生—泌尿科学]