老年早期前列腺癌患者腹腔镜前列腺癌根治术后尿路感染的病原菌分布及耐药性分析  

Pathogenic bacteria distribution and drug resistance analysis of urinary tract infection after laparoscopic radical prostatectomy in elderly patients with early prostate cancer

作　　者：贾自晓 JIA Zixiao(Department of Clinical Laboratory,Tongxu First Hospital,Kaifeng 475400,Henan Province,China)

机构地区：[1]通许第一医院检验科,河南开封475400

出　　处：《新乡医学院学报》2024年第9期862-866,873,共6页Journal of Xinxiang Medical University

摘　　要：目的探讨老年早期前列腺癌患者腹腔镜前列腺癌根治术后尿路感染的病原菌分布及耐药性。方法选择2021年1月至2023年10月在通许第一医院完成腹腔镜前列腺癌根治术后发生尿路感染的148例老年早期前列腺癌患者为研究对象。患者在明确发生尿路感染后接受中段尿液病原菌培养鉴定及药敏试验。查阅病历资料,记录患者病原菌培养鉴定及主要病原菌的药敏试验结果。结果148例尿路感染患者中段尿标本中共分离出156株病原菌,其中真菌8株(5.13%),革兰阳性菌50株(32.05%),革兰阴性菌98株(62.82%)。8株真菌中,白色假丝酵母菌6株(75.00%),其他菌2株(25.00%);50株革兰阳性菌中,粪肠球菌23株(46.00%),金黄色葡萄球菌11株(22.00%),屎肠球菌9株(18.00%),表皮葡萄球菌7株(14.00%);98株革兰阴性菌中,大肠埃希菌56株(57.14%),肺炎克雷伯菌20株(20.41%),鲍氏不动杆菌8株(8.16%),阴沟肠杆菌8株(8.16%),铜绿假单胞菌6株(6.12%)。大肠埃希菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉、头孢曲松的耐药率较高(57.14%~80.36%),对美罗培南、亚胺培南、阿米卡星、替加环素、呋喃妥因的耐药率较低(1.79%~3.57%);肺炎克雷伯菌对氨苄西林、阿奇霉素、氨苄西林/舒巴坦、头孢曲松、头孢唑啉的耐药率较高(55.00%~80.00%),对庆大霉素、阿米卡星、替加环素的耐药率较低(5.00%~10.00%);粪肠球菌对庆大霉素、青霉素G、环丙沙星、红霉素、左氧氟沙星、利奈唑胺的耐药率较高(47.83%~91.30%),对万古霉素、替考拉宁、呋喃妥因的耐药率较低(4.35%~8.70%);金黄色葡萄球菌对青霉素、红霉素、链霉素、氨苄西林耐药率较高(81.82%~100.00%),对万古霉素、利奈唑胺、替考拉宁、呋喃妥因耐药率较低(0.00%~9.09%)。结论老年早期前列腺癌患者腹腔镜前列腺癌根治术后尿路感染以革兰阴性菌为主,临床治疗需依据药敏试验结果并结合患者自身情况选�Objective To analyze the distribution and drug resistance of pathogens causing urinary tract infections in elderly patients with early prostate cancer after laparoscopic radical prostatectomy.Methods Totally 148 elderly early-stage prostate cancer patients who underwent laparoscopic radical prostatectomy at Tongxu First Hospital from January 2021 to October 2023 and developed urinary tract infections were selected as the research subjects.After confirming the occurrence of urinary tract infections,the patients underwent mid-stream urine pathogen culture and identification and drug susceptibility testing.The medical records were checked and the results of the culture and identification of pathogenic bacteria and drug susceptibility testing of the main pathogenic bacteria were recorded.Results A total of 156 strains of pathogenic bacteria were collected from 148 patients with urinary tract infections.There were 8 strains of fungi(5.13%),50 strains of Gram-positive bacteria(32.05%)and 98 strains of Gram-negative bacteria(62.82%).Among the 8 fungi strains,6 were Canidia albicans(75.00%)and 2 were other fungi(25.00%).Among the 50 Gram-positive bacteria,23 were Enterococcus faecalis(46.00%),11 were Staphylococcus aureus(22.00%),9 were Enterococcus faecium(18.00%),and 7 were Staphylococcus epidermidis(14.00%).Among the 98 strains of Gram-negative bacteria,56 strains were Escherichia coli(57.14%),20 strains were Klebsiella pneumoniae(20.41%),8 strains were Acinetobacter baumannii(8.16%),8 strains were Enterobacter cloacae(8.16%),and 6 strains were Pseudomonas aeruginosa(6.12%).The resistance rate of Escherichia coli to ampicillin,ampicillin/sulbactam,cefazolin and ceftriaxone was relatively high(57.14%-80.36%),while the resistance rate to meropenem,imipenem,amikacin,tigecycline and furantoin was relatively low(1.79%-3.57%).Klebsiella pneumoniae had a high resistance rate(55.00%-80.00%)to ampicillin,azithromycin,ampicillin/sulbactam,ceftriaxone and cefazolin,while a low resistance rate(5.00%-10.00%)to gentamicin,amikacin

关 键 词：早期前列腺癌 腹腔镜根治术 尿路感染 病原菌 耐药性 

分 类 号：R737[医药卫生—肿瘤]