2016—2021年某医院泌尿系细菌感染及影响分析  

Analysis of bacterial infections in urinary system and influencing factor in a hospital from 2016 to 2021

作　　者：孔亚丽 邱玉 郭秀美 赵秀民 王玲玲 刘利利 李明芝 KONG Yali;QIU Yu;GUO Xiumei;ZHAO Xiumin;WANG Lingling;LIU Lili;LI Mingzhi(Department of Critical Rehabilitation,The Third Hospital of Shandong Province,Ji′nan,Shandong 250000,China;不详)

机构地区：[1]山东省立第三医院重症康复科,山东济南250000 [2]山东省立第三医院康复科 [3]章丘市人民医院 [4]禹城市人民医院

出　　处：《医学动物防制》2024年第4期376-379,共4页Journal of Medical Pest Control

基　　金：山东省卫生厅指导性科研计划项目(SG20201223)。

摘　　要：目的分析2016—2021年某医院脊髓损伤(spinal cord injury,SCI)住院患者泌尿系感染及影响因素。方法选取2016—2021年入住该院接受治疗的3000例SCI患者,采用药敏试验法分析尿液样本中病原菌耐药性,分析SCI患者临床资料和病原菌耐药性的差异。结果3000例SCI患者,发生院内泌尿系统感染的占29.17%,共分离1168株菌株,革兰阴性菌中主要病原菌为大肠埃希菌(41.18%)、肺炎克雷伯菌(12.41%)、变形杆菌属(6.34%)、铜绿假单胞菌(4.02%),对阿莫西林、环丙沙星、舒巴坦、复方磺胺、庆大霉素等有较高耐药性,对阿米卡星、头孢他啶、氨曲南等有较高敏感性;革兰阳性菌中主要病原菌为屎肠球菌(8.73%)和粪肠球菌(6.93%),屎肠球菌对青霉素、环丙沙星和呋喃妥因呈高耐药性,粪肠球菌对四环素呈高耐药性,两种菌株对万古霉素和替考拉宁均为100.00%敏感;年龄≥60岁、完全性损伤、应用抗生素药物、住院期间发生压疮、侵入性操作等均为SCI患者住院期间发生泌尿系感染的危险因素。结论SCI患者住院期间发生泌尿系感染比例较高,临床中应及时留取尿样本送检并针对性选择抗菌药物,同时对并发泌尿系细菌感染危险因素进行防控。Objective To analyze infections in urinary system and influencing factors in inpatients with spinal cord injury(SCI)in a hospital from 2016 to 2021.Methods A total of 3000 SCI patients admitted to the hospital for treatment from 2016 to 2021 were selected.The drug sensitivity test method was used to analyze the drug resistance of pathogenic bacteria in urine samples,and the differences in clinical data and pathogenic bacteria resistance of SCI patients were analyzed.Results Of the 3000 SCI patients had nosocomial urinary system infection in 29.17%and a total of 1168 strains were isolated.The main pathogenic bacteria of Gram-negative bacteria were Escherichia coli(41.18%),Klebsiella pneumoniae(12.41%),Proteus spp.(6.34%),and Pseudomonas aeruginosa(4.02%),with high resistance to amoxicillin,ciprofloxacin,sulbactam,compound sulfanilamide and gentamicin,and high sensitivity to amikacin,ceftazidime,and aztreonam.The main pathogenic bacteria of Gram-positive bacteria were Enterococcus faecium(8.73%)and Enterococcus faecalis(6.93%).Enterococcus faecium showed high resistance to penicillin,ciprofloxacin,and nitrofurantoin.Enterococcus faecalis showed high resistance to tetracycline.Both strains were 100.00%sensitive to vancomycin and teicoranin.Ages≥60 years old,complete injuries,application of antibiotic drugs,pressure ulcers during hospitalization,and invasive procedures etcetera were all risk factors for urinary tract infections during hospitalization in SCI patients.Conclusion The proportion of infection in urinary system in patients with SCI is high during hospitalization.In clinical practice,urine samples should be collected for examination and antibiotics should be selected in time,and the risk factors of concurrent bacterial infection in urinary system should be prevented and controlled.

关 键 词：脊髓损伤 泌尿系统 细菌感染 病原菌特征 耐药性 影响因素 分析 

分 类 号：R651.2[医药卫生—外科学]