尿石症患者尿菌、药敏谱及临床指导意义  

Urinary Bacteria,Drug Sensitivity Spectrum and Clinical Guidance Significance in Patients With Urolithiasis

作　　者：冯友玉 陈武 肖方洪 邱赟 FENG Youyu;CHEN Wu;XIAO Fanghong;QIU Yun(Department of Laboratory Medicine,Traditional Chinese Medicine Hospital of Ningde,Ningde Fujian 352100,China)

机构地区：[1]宁德市中医院检验科,福建宁德352100

出　　处：《中国卫生标准管理》2024年第11期91-94,共4页China Health Standard Management

基　　金：福建中医药大学校管临床专项科研课题(XB2022092)。

摘　　要：目的分析尿石症患者尿常规结果结合致病菌谱和药敏谱,提高对其抗生素使用的规范性和针对性。方法选取宁德市中医院2021年6月—2023年5月369例尿石症患者中段尿标本,将尿干化学白细胞酯酶和亚硝酸盐的结果与尿培养及药敏结果进行多层面分析。结果白细胞酯酶的敏感度为96.23%、特异度为22.78%;亚硝酸盐的敏感度为33.96%、特异度为90.00%。其中尿液培养检出致病菌53例,其中大肠埃希菌29例(54.72%)和粪肠球菌6例(11.32%)。结论尿白细胞酯酶与亚硝酸盐阳性的样本易培养出革兰阴性菌,较大可能是大肠埃希菌。因此,建议若细菌的培养及药敏结果未出,则可依据尿常规结果结合本文药敏谱作为经验治疗。Objective To improve the standardization and targeting of antibiotic use in patients with urolithiasis by analyzing the results of urine routine combined with the spectrum of pathogenic bacteria and drug sensitivity.Methods A total of 369 middle stage urine samples from patients with urolithiasis at Traditional Chinese Medicine Hospital of Ningde from June 2021 to May 2023 were selected.The results of urine dry chemistry,white blood cell esterase and nitrite,as well as urine culture and drug sensitivity results were analyzed at multiple levels.Results The sensitivity and specificity of leukocyte esterase were 96.23%and 22.78%,respectively.The sensitivity and specificity of nitrite were 33.96%and 90.00%,respectively.Among them,53 cases of pathogenic bacteria were detected in urine culture,consisting of 29 cases of Escherichia coli(54.72%)and 6 cases of Enterococcus faecalis(11.32%).Conclusion Urinary leukocyte esterase and nitrite positive samples are more likely to cultivate Gram negative bacteria,possibly Escherichia coli.Therefore,it is recommended that if bacterial culture and drug sensitivity results are not available,empirical treatment can be based on urine routine results combined with the drug sensitivity spectrum in this article.

关 键 词：尿石症 尿菌 白细胞酯酶 亚硝酸盐 敏感度 特异度 

分 类 号：R543[医药卫生—心血管疾病]