膀胱癌患者经尿道电切术后合并尿道感染病原菌分布及药物敏感性分析  

Distribution of isolated pathogenic bacteria and drug sensitivity analysis of bladder cancer patients complicated with urethral infection after transurethral resection

作　　者：董贺楠 王景雨 王猛[2] 赵洁 周春雷[2] 穆红[2] 崔川跃 冯玉庆 彭林[2] DONG Henan;WANG Jingyu;WANG Meng;ZHAO Jie;ZHOU Chunlei;MU Hong;CUI Chuanyue;FENG Yuqing;PENG Lin(The First Central Clinical School,Tianjin Medical University,Tianjin 300192,China;Department of Clinical Laboratory,Tianjin First Central Hospital,Tianjin 300192,China;Clinical College of Jiamusi Medical University,Jiamusi 154007,China;Department of Pathology,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津医科大学一中心临床学院,天津300192 [2]天津市第一中心医院检验科,天津300192 [3]佳木斯医科大学临床学院,佳木斯154007 [4]天津市第一中心医院病理科,天津300192

出　　处：《天津医科大学学报》2024年第4期323-327,共5页Journal of Tianjin Medical University

基　　金：天津市卫健委科技项目(TJWJ2021QN016);天津市医学重点学科建设项目(2021);天津市第一中心医院青年新锐项目(2022)。

摘　　要：目的:分析膀胱癌(BCa)患者经尿道电切术后合并尿道感染(UTI)病原菌分布特征及药敏特点。方法:回顾性分析2021年7月—2023年8月天津市第一中心医院泌尿外科经尿道电切术后合并UTI的BCa患者尿液中病原菌的种类分布和药物敏感性数据。结果:共分离培养出164株病原菌,其中革兰阴性(G-)杆菌78株(47.6%),以大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌为主;革兰阳性(G+)球菌76株(46.3%),主要为凝固酶阴性葡萄球菌属(CoNS)和肠球菌属;真菌10株(6.1%),主要以念珠菌属为主。G-杆菌中大肠埃希菌对左氧氟沙星耐药率高达83.87%;肺炎克雷伯菌对头孢曲松的耐药率高达66.67%;阴沟肠杆菌对头孢西丁、阿莫西林耐药率高达100%。G+球菌中表皮葡萄球菌对青霉素(95%)、红霉素(80%)耐药率较高;粪肠球菌对红霉素耐药率高达68.42%;屎肠球菌对红霉素、青霉素、左氧氟沙星耐药率均为100%。本研究未检测到耐药真菌。结论:尿道电切术后合并UTI尿液中分离病原菌以G-杆菌和G+球菌为主。分离病原菌对抗菌药物的敏感性有较明显差异。Objective:To analyze the clinical pathogenic bacteria distribution and drug sensitivity characteristics of bladder cancer(BCa)patients complicated with urinary tract infection(UTI)after transurethral resection.Methods:The species distribution and drug sensitivity data of pathogens in urine of BCa patients with UTI after transurethral resection in the Department of Urology,Tianjin First Central Hospital from July 2021 to August 2023 were retrospectively analyzed.Results:A total of 164 pathogenic bacteria were isolated and cultured,of which 78(47.6%)were Gram-negative(G-)bacilli,mainly Escherichia coli,Klebsiella pneumoniae and Enterobacter cloformis.There were 76 cases(46.3%)of Gram-positive(G+)micrococcus,mainly coagulase negative Staphylococcus(CoNS)and Enterococcus.There were 10 cases(6.1%)of fungi,mainly Candida.The resistance rate of Escherichia coli to levofloxacin was 83.87%.The resistance rate of Klebsiella pneumoniae to ceftriaxone was 66.67%.The resistance rate of enterobacter cloacae to cefoxitin and amoxicillin was up to 100%.Staphylococcus epidermidis had a higher resistance rate to penicillin(95%)and erythromycin(80%)in G+cocci.The resistance rate of enterococcus faecalis to erythromycin was 68.42%.The resistance rate of Enterococcus faecium to erythromycin,penicillin and levofloxacin was 100%.No drug-resistant fungi were detected in this study.Conclusion:The main pathogens isolated in urine of BCa patients with UTI after transurethral resection are G-Bacillus and G+coccus.The sensitivity of isolated pathogens to antimicrobial agents is significantly different.

关 键 词：膀胱癌 尿道感染 病原菌 耐药性 泌尿系统 

分 类 号：R446.5[医药卫生—诊断学]