对1例粪肠球菌、摩根摩根菌导尿管相关泌尿系感染患者的抗感染治疗分析  

Analysis on anti-infection treatment of a patient with urinary duct-related urinary tract infection of Enterococcus faecalis and Morganella morganii

作　　者：马红玲 MA Hong-ling(Pharmacy Department,Inner Mongolia People’s Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古自治区人民医院药学处,呼和浩特010017

出　　处：《医药论坛杂志》2022年第2期64-67,共4页Journal of Medical Forum

摘　　要：目的探讨粪肠球菌、摩根摩根菌泌尿系感染的治疗方案。方法对内蒙古自治区人民医院2020年12月26日收住入院的1例老年男性留置导尿管,先后粪肠球菌、摩根摩根菌泌尿系感染病例介绍,对抗感染方案进行用药分析。结果本例患者泌尿系感染合并肺部感染,尿液中先后培养出粪肠球菌、摩根摩根菌,给予莫西沙星、苯唑西林后肺部感染好转,泌尿系感染疗效欠佳,改用美罗培南抗感染后症状好转。结论粪肠球菌为男性泌尿系感染的第二大病原菌,粪肠球菌对耐酶青霉素、头孢菌素、克林霉素、低浓度氨基糖苷类天然耐药,全国细菌耐药监测报告(2020)显示对利奈唑胺、磷霉素、呋喃妥因、氨苄西林敏感率较高,耐药率分别为3.3%、3.6%、2.7%、3.8%,对左氧氟沙星、环丙沙星耐药率约30%,对红霉素耐药率60%以上。摩根摩根菌是一种罕见机会致病菌,可引起各组织器官感染,常见泌尿道和伤口感染,摩根摩根菌对大多数第一、二代头孢菌素天然耐药,对磷霉素、大环内酯类、林可酰胺类及多黏菌素类抗生素也耐药,全国细菌耐药监测报告(2020)显示摩根菌属对阿米卡星、美罗培南较敏感,耐药率小于2%,对厄他培南、哌拉西林他唑巴坦、头孢哌酮舒巴坦耐药率2%~3%。两种菌耐药性严重,应根据药敏结果选择药物。Objective To discuss the treatment of urinary tract infections caused by Enterococcus faecalis and Morganella morganii.Methods An elderly man with an indwelling urinary catheter was introduced successively with Enterococcus faecalis and Morganella morganii urinary tract infections.The anti-infection plan was used for drug analysis.Results In this case,urinary tract infection combined with pulmonary infection.Enterococcus faecalis and Morganella morganii were cultured in the urine.After administration of moxifloxacin and oxacillin,the pulmonary infection improved,and the effect of urinary tract infection was not good.Symptoms improved after meropenem was resistant to infection.Conclusion Enterococcus faecalis is the second major pathogen of male urinary tract infections.Enterococcus faecalis is naturally resistant to enzyme-resistant penicillins,cephalosporins,clindamycin,and low-concentration aminoglycosides.National bacterial resistance monitoring report(2020)) Showed a high sensitivity rate to linezolid,fosfomycin,nitrofurantoin,and ampicillin.The drug resistance rates were 3.3%,3.6%,2.7%,and 3.8%,respectively,and the drug resistance rate to levofloxacin and ciprofloxacin was about 30%,The resistance rate to erythromycin is more than 60%.Morganella morganii is a rare opportunistic pathogen that can cause infections in various tissues and organs,common urinary tract and wound infections.Morganella morganii is naturally resistant to most first and second-generation cephalosporins,and is resistant to fosfomycin and Cyclolactones,lincosamides and polymyxin antibiotics are also resistant.The National Bacterial Resistance Surveillance Report(2020) shows that Morganella is more sensitive to amikacin and meropenem,with a resistance rate of less than 2%,The resistance rate to ertapenem,piperacillin,tazobactam,cefoperazone and sulbactam is 2%~3%.The two kinds of bacteria have serious drug resistance,and drugs should be selected based on the results of drug susceptibility.

关 键 词：粪肠球菌 摩根摩根菌 泌尿系感染 

分 类 号：R691.3[医药卫生—泌尿科学]