男性尿道狭窄患者尿路感染病原菌与耐药性的单中心分析  

Analysis of pathogens and drug resistance in male urethral stricture patients with urinary tract infection:a single⁃center study

作　　者：黄正楷[1] 费爽[1] 高翔 韩前广 谭若芸 居小兵[1] 陶俊[1] 顾民[1,2] HUANG Zhengkai;FEI Shuang;GAO Xiang;HAN Qianguang;TAN Ruoyun;JU Xiaobing;TAO Jun;GU Min(Department of Urology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Urology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第一附属医院泌尿外科,江苏南京210029 [2]南京医科大学第二附属医院泌尿外科,江苏南京210011

出　　处：《南京医科大学学报（自然科学版）》2023年第12期1699-1706,共8页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省人民医院临床能力提升工程项目(JSPH⁃MC⁃2022⁃8)。

摘　　要：目的:分析男性尿道狭窄患者尿路感染情况和病原菌分布与耐药特点。方法:选取2021年1月—2022年8月于本院收治的男性尿道狭窄患者为研究对象,通过收集临床资料和实验室检查结果,分析患者尿路感染及感染病原菌分布与耐药情况。结果:共纳入187例男性尿道狭窄患者,132例(70.6%)发生尿路感染,病原学检测发现106例(56.7%)尿培养阳性。共培养分离病原菌111株,其中革兰阳性菌42株占37.8%,以表皮葡萄球菌、粪肠球菌为主,对左氧氟沙星的耐药率均>70%,对万古霉素、替加环素和呋喃妥因的敏感率均为100%;革兰阴性菌63株占56.8%,以大肠埃希菌、肺炎克雷伯菌为主,对头孢替坦、妥布霉素、美罗培南、哌拉西林/他唑巴坦、亚胺培南和阿米卡星的耐药率<30%;真菌6株占5.4%,以光滑假丝酵母为主。尿路感染组中患者40~65岁、膀胱造瘘的比例显著高于无感染组(P<0.05)。结论:男性尿道狭窄患者尿路感染的发病率高,主要病原菌为大肠埃希菌、表皮葡萄球菌,病原菌耐药相对严重,术前需根据药敏情况合理使用抗菌药物。Objective:To analyze the urinary tract infection situation,pathogens,and drug resistance characteristics in male urethral stricture patients.Methods:Male patients with urethral stricture admitted to our hospital from January 2021 to August 2022 were enrolled.Clinical data and laboratory test results were collected to analyze the urinary tract infection,pathogen distribution,and drug resistance situation in the patients.Results:A total of 187 male urethral stricture patients were included,with132 cases(70.6%)experiencing urinary tract infections.Microbiological testing revealed positive urine cultures in 106 cases(56.7%).A total of 111 strains of isolated pathogens were cultured,including 42 strains of Gram⁃positive bacteria,accounting for 37.8%,mainly Staphylococcus epidermidis and Enterococcus faecalis,with resistance rate to levofloxacin exceeding 70%and sensitivity rates to vancomycin,tigecycline and nitrofurantoin all at 100%;63 strains of Gram⁃negative bacteria,accounting for 56.8%,mainly Escherichia coli and Klebsiella pneumoniae,with resistance rate to cefotetan,tobramycin,meropenem,piperacillin/tazobactam,imipenem,and amikacin all below 30%;and 6 strains of fungi,accounting for 5.4%,mainly Candida glabrata.The proportion of patients aged 40⁃65 years and those with suprapubic catheter in the urinary tract infection group was significantly higher than that in the non⁃infection group(P<0.05).Conclusion:The incidence of urinary tract infection is high in male urethral stricture patients,with the main pathogens being E.coli and S.epidermidis.The drug resistance of the pathogens is relatively strong.Antimicrobial agents should be used rationally according to drug sensitivity before surgery.

关 键 词：尿道狭窄 尿路感染 病原菌 耐药 

分 类 号：R591.3[医药卫生—内科学]