妇科恶性肿瘤患者尿路感染病原菌及耐药性分析  

Distribution and antimicrobial resistance of pathogenic bacteria for urinary tract infections among patients with gynecological malignancies

作　　者：郭爱华[1] 谢建忠[2] 钟沛霖 辛娜[3] 王玲华[1] 林秀容 冯梅 GUO Aihua;XIE Jianzhong;ZHONG Peilin;XIN Na;WANG Linghua;LIN Xiurong;FENG Mei(Department of Gynecology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,China;Department of Hospital-Acquired Infection Control,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital;Department of Laboratory Medicine,Clinical Oncology School of Fujian Medical University,Fujian CancerHospital)

机构地区：[1]福建医科大学肿瘤临床医学院,福建省肿瘤医院妇科,福建福州350014 [2]福建医科大学肿瘤临床医学院,福建省肿瘤医院感染科 [3]福建医科大学肿瘤临床医学院,福建省肿瘤医院检验科

出　　处：《中国病原生物学杂志》2023年第11期1329-1332,共4页Journal of Pathogen Biology

摘　　要：目的分析妇科恶性肿瘤患者尿路感染病原菌分布及病原菌对常见抗菌药物的敏感性,从而为制定患者干预方案、提高患者生活质量提供参考依据。方法以经病理确诊的127例妇科恶性肿瘤患者为研究对象,采集患者尿液样本。采用BD Phoenix-100全自动微生物鉴定及药敏分析仪鉴定尿液中的病原菌种类,采用Mueller-Hinton琼脂平板和Kirby-Bauer纸片扩散法测定尿液中分离的主要病原菌菌株对常见抗菌药物的敏感性。结果累计开展尿液培养638次,阳性219次,阳性率为34.33%。累计培养出病原菌273株,以大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌为主。大肠埃希菌对厄他培南100%敏感,对美罗培南、阿米卡星、亚胺培南敏感性均>95%,对氨苄西林、哌拉西林耐药性均>85%;肺炎克雷伯菌对美罗培南、阿米卡星100%敏感,对头孢唑啉耐药性较高;金黄色葡萄球菌对苯唑西林、阿莫西林克拉维酸、庆大霉素、万古霉素、替考拉宁、呋喃妥因、复方新诺明、利奈唑胺、利福平100%敏感,对氨苄西林、青霉素和环丙沙星100%耐药。结论大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌是引发妇科恶性肿瘤患者尿路感染的主要病原菌。大肠埃希菌对厄他培南、美罗培南、阿米卡星、亚胺培南敏感性较高,对氨苄西林、哌拉西林敏感性较低;肺炎克雷伯菌对美罗培南、阿米卡星100%敏感,对头孢唑啉敏感性较低;金黄色葡萄球菌对苯唑西林、阿莫西林克拉维酸、庆大霉素、万古霉素、替考拉宁、呋喃妥因、复方新诺明、利奈唑胺、利福平100%敏感,对氨苄西林、青霉素和环丙沙星100%耐药。Objective To investigate the distribution of pathogenic bacteria for urinary tract infections among patients with gynecological malignancies and to test the susceptibility of pathogenic bacteria to common antimicrobial agents,so as to provide insights into the formulation of interventions against urinary tract infections and improvements of the quality of life among patients with gynecological malignancies.Methods A total of 127 patients with pathological diagnosis of gynecological malignancies were enrolled,and urine samples were collected.The pathogenic bacteria in urine samples were identified using the BD Phoenix-100 automated identification and susceptibility testing system,and the susceptibility of major pathogenic bacteria to common antimicrobial agents was tested with Mueller-Hinton agar plates and Kirby-Bauer disk diffusion method.Results A total of 638 urine culture tests were performed,and the positive rate of urine culture was 34.33%(219/638).Escherichia coli,Klebsiella pneumoniae and Staphylococcus aureus were predominant among 273 bacterial isolates from urine samples.E.coli was 100%susceptible to ertapenem and showed more than 95%susceptibility to meropenem,amikacin,imipenem,and more than 85%resistance to ampicillin and piperacillin.K.pneumoniae was 100%susceptible to meropenem and amikacin and high resistance to cefazolin.S.aureus was 100%susceptible to oxacillin,amoxicillin clavulanate,gentamicin,vancomycin,teicoplanin,nitrofurantoin,trimethoprim/sulfamethoxazole,linezolid and rifampicin,and 100%resistant to ampicillin,penicillin and ciprofloxacin.Conclusion E.coli,K.pneumoniae and S.aureus are predominant pathogenic bacterial isolates causing urinary tract infections among patients with gynecological malignancies.E.coli shows a high susceptibility to ertapenem,meropenem,amikacin and imipenem,and high resistance to ampicillin and piperacillin.K.pneumoniae is 100%susceptible to meropenem and amikacin and shows a low susceptibility to cefazolin.S.aureus is 100%susceptible to oxacillin,amoxicillin c

关 键 词：病原菌 抗生素耐药性 尿路感染 妇科恶性肿瘤 

分 类 号：R378[医药卫生—病原生物学]