泌尿外科术后泌尿系统感染大肠埃希菌耐药调查  

Investigation on Drug Resistance of Escherichia coli in Urinary Tract Infection after Urology Surgery

作　　者：万滨[1] Wan Bin(Jiujiang First People's Hospital,Jiujiang Jiangxi 332000)

机构地区：[1]九江市第一人民医院,江西九江332000

出　　处：《国外医药（抗生素分册）》2021年第6期377-380,共4页World Notes on Antibiotics

摘　　要：目的调查泌尿外科术后泌尿系统感染大肠埃希菌的耐药性。方法选取2016年5月—2020年9月于我院收治的152例泌尿外科术后泌尿系统感染(UTI)患者作为研究对象,采用Vitek-32自动化细菌分析仪和纸片扩散法分别进行病原菌鉴定和药敏试验,分析152例UTI患者的大肠埃希菌检出情况和耐药性。结果 152例患者共检出致病菌152株,检出率100%,且主要为大肠埃希菌,占比56.58%;大肠埃希菌在泌尿系结石、前列腺疾病和膀胱癌中的检出率存在明显差异(P<0.05)。药敏结果显示,86株大肠埃希菌对亚胺培南、美罗培南、阿米卡星和呋喃妥因的耐药率较低,分别为1.16%、1.16%、6.98%和8.14%;且86株大肠埃希菌中产ESBLs菌株54株(62.79%),非产ESBLs菌株为32株(37.21%);产ESBLs菌株对头孢噻肟等头孢菌素类抗菌药物的耐药率均大于非产ESBLs菌株(P<0.05)。与≤60岁患者相比,61~70岁、71~80岁和>80岁患者对头孢噻肟的耐药率明显升高(P<0.05),>80岁患者对头孢他啶、哌拉西林、环丙沙星和头孢吡肟的耐药率明显升高(P<0.05)。结论大肠埃希菌是泌尿外科术后泌尿系感染的主要病原菌,且多为产ESBLs菌株,其对亚胺培南、美罗培南、阿米卡星等耐药性较低;且大肠埃希菌对头孢噻肟、头孢他啶、哌拉西林、环丙沙星和头孢吡肟的耐药率随着年龄的增长逐渐增高,临床上应重点监测老年泌尿外科术患者耐药情况,合理选择抗生素,以提高抗菌药物疗效。Objective To investigate the drug resistance of Escherichia coli in urinary tract infection (UTI) after urology surgery.Methods A total of 152 patients with UTI after urology surgery admitted to the hospital were enrolled as the research objects from May 2016 to September 2020.The pathogens identification and drug sensitivity tests were conducted by Vitek-32 automated bacteria analyzer and disc diffusion method,respectively.The detection and drug resistance of Escherichia coli were analyzed.Results There were 152 strains of pathogenic bacteria detected from the 152 patients,with detection rate of 100%.They were mainly on Escherichia coli (56.58%).There were significant differences in the detection rate of Escherichia coli among urinary calculi,prostate disease and bladder cancer (P<0.05).The results of drug sensitivity tests showed that resistance rates of the 86 strains of Escherichia coli were low to imipenem,meropenem,amikacin and nitrofurantoin (1.16%,1.16%,6.98%,8.14%).Among the 86 strains of Escherichia coli,there were 54 strains (62.79%) ESBLs-producing strains and 32 strains (37.21%) ESBLs non-producing strains.The resistance rate of ESBLs-producing strains to cefotaxime and other cephalosporin antibiotics was higher than of ESBLs non-producing strains (P<0.05).Compared with patients not older than 60 years,drug resistance rate to cefotaxime was significantly increased in those aged 61~70 years,71~80 years and over 80 years (P<0.05),and drug resistant rates to ceftazidime,piperacillin,ciprofloxacin and cefepime were significantly increased in those over 80 years (P<0.05).Conclusion Escherichia coli is the main pathogen of UTI after urology surgery,mainly on ESBLs-producing strains.And the resistant to imipenem,meropenem and amikacin is low.The resistance rates of Escherichia coli to cefotaxime,ceftazidime,piperacillin,ciprofloxacin and cefepime gradually increase with age.Clinically,drug resistance of elderly patients after urology surgery should be emphatically monitored,and antibiotics should be reasona

关 键 词：泌尿外科术 泌尿系感染 大肠埃希菌 药敏试验 耐药性 

分 类 号：R978.1[医药卫生—药品]