产超广谱β-内酰胺酶菌的耐药性及其致尿路感染的危险因素分析  

Analysis of drug resistance and risk factors of urinary tract infection caused by extended-spectrumβ-lactamases-producing bacteria

作　　者：付晓峰 FU Xiaofeng(Laboratory Department,the First People's Hospital of Luoyang,Luoyang 471002,China)

机构地区：[1]洛阳市第一人民医院检验科,河南洛阳471002

出　　处：《临床医学研究与实践》2022年第8期12-14,共3页Clinical Research and Practice

摘　　要：目的分析产超广谱β-内酰胺酶(ESBLs)菌的耐药性及其致尿路感染的危险因素。方法回顾性选取2019年1月至2021年1月本院细菌室尿培养结果为革兰阴性杆菌感染标本113例,其中产ESBLs菌尿路感染63例,非产ESBLs菌尿路感染50例。进行药敏试验,分析产ESBLs菌的耐药性。采用多因素Logistic回归分析探讨产ESBLs菌致尿路感染的危险因素。结果产ESBLs菌对帕拉西林、头孢哌酮、头孢噻肟、头孢吡肟、头孢他啶、头孢曲松、头孢呋辛钠、氨曲南、头孢唑林的耐药性最高,为100.0%,对美罗培南、亚胺培南的耐药性最低,为0.0%,对环丙沙星、氨苄西林的耐药性均为95.2%,其余由高到低依次为左旋氧氟沙星、阿莫西林/克拉维酸、庆大霉素、氧氟沙星、复方新诺明、妥布霉素、氨苄西林/舒巴坦、头孢哌酮/舒巴坦、阿米卡星、头孢西丁、呋喃妥因、帕拉西林/他唑巴坦。单因素分析结果显示,两组的性别、年龄、糖尿病、前列腺疾病、肾结石、慢性肾功能衰竭、膀胱镜检查、逆行性肾盂造影比较,差异无统计学意义(P>0.05);两组的留置尿管、治疗方法、抗生素应用比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,留置尿管、第3代头孢菌素类是产ESBLs菌致尿路感染的危险因素(P<0.05)。结论产ESBLs菌对多种抗菌药物具有耐药性,留置尿管、第3代头孢菌素类是产ESBLs菌致尿路感染的危险因素,针对此类患者,临床应尽量减少尿管的留置及第3代头孢菌素类的应用。Objective To analyze the drug resistance and risk factors of urinary tract infection caused by extended-spectrumβ-lactamases(ESBLs)-producing bacteria.Methods From January 2019 to January 2021,113 samples of Gram-negative bacilli infected by bacterial urine culture in our hospital were selected retrospectively,including 63 cases of urinary tract infection caused by ESBLs-producing bacteria and 50 cases of urinary tract infection caused by non-ESBLs-producing bacteria.The drug resistance of ESBLs-producing bacteria was analyzed by drug sensitivity test.Multivariate Logistic regression analysis was used to explore the risk factors of urinary tract infection caused by ESBLs-producing bacteria.Results The drug resistance of ESBLs-producing bacteria to paracillin,cefoperazone,cefotaxime,cefepime,ceftazidime,ceftriaxone,cefuroxime sodium,aztreonam and cefazolin were the highest,all of which were 100.0%;the drug resistance to meropenem and imipenem were the lowest,0.0%,the drug resistance to ciprofloxacin and ampicillin were 95.2%;the others from high to low were levofloxacin,amoxicillin/clavulanic acid,gentamicin,ofloxacin,cotrimoxazole,tobramycin,ampicillin/sulbactam,cefoperazone/sulbactam,amikacin,cefoxitin,furantoin and paxilin/tazobactam.Univariate analysis showed that there were no significant differences in gender,age,diabetes mellitus,prostatic diseases,renal calculus,chronic renal failure,cystoscopy and retrograde pyelography between the two groups(P>0.05);there were significant differences in indwelling catheter,treatment methods and antibiotic application between the two groups(P<0.05).The multivariate Logistic regression analysis showed that indwelling urinary catheter and third-generation cephalosporins were the risk factors of urinary tract infection caused by ESBLs-producing bacteria(P<0.05).Conclusion ESBLs-producing bacteria have drug resistance to a variety of antibiotics.Indwelling urinary catheter and the third-generation cephalosporins are the risk factors of urinary tract infection caused by ESBLs

关 键 词：产超广谱Β-内酰胺酶菌 耐药性 尿路感染 第三代头孢菌素 

分 类 号：R37[医药卫生—病原生物学]