前列腺癌术后尿路感染病原菌分布及耐药性分析  

Distribution of pathogens causing urinary tract infections and antimicrobial resistance among prostate cancer patients follow ing surgical treatment

作　　者：崔寿喜 梁斌 CUI Shouxi;LIANG Bin(Deparment of Urology Sargery.Changzhou Cancer Hospital and Changzhou Fourth People's Hos pital.Changzhou,Jiangsu 213001,China)

机构地区：[1]江苏省常州市肿瘤医院,常州市第四人民医院泌尿外科,江苏常州213001

出　　处：《中国病原生物学杂志》2024年第12期1483-1486,1491,共5页Journal of Pathogen Biology

基　　金：江苏省常州市科学技术局基础研究项目(No.CJ20220212)。

摘　　要：目的 鉴定前列腺癌患者术后尿路感染致病菌种类,测定分离的细菌对常见抗菌药物的敏感性。方法 以2020年1月至2024年2月行手术治疗的前列腺癌患者且术后发生尿路感染的病例为研究对象。无菌收集患者尿液样本,采用XD200全自动快速微生物培养与鉴定系统鉴定病原菌,采用圆纸片扩散试验法测定分离的主要细菌菌株对常见抗菌药物的敏感性。结果 自107例前列腺癌术后尿路感染病例采集的尿液样本中,共检出141株病原菌,以革兰阴性菌为主(占63.83%),其次为革兰阳性菌(占29.08%)和真菌(占7.09%);革兰阳性菌以粪肠球菌和屎肠球菌为主(均占分离菌株总数的10.64%),革兰阴性菌以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主。粪肠球菌、屎肠球菌、金黄色葡萄球菌对青霉素G均100.00%耐药,对万古霉素、利奈唑胺、替加环素100.00%敏感;粪肠球菌对氨苄西林耐药性较高(97.25%),屎肠球菌对利福平耐药性较高(88.20%),金黄色葡萄球菌对妥布霉素100.00%耐药、对利福平(90.23%)和氨苄西林(87.21%)耐药性亦较高。大肠埃希菌对氨苄西林、头孢唑啉、氨苄西林/舒巴坦耐药性较高,对亚胺培南、阿米卡星较敏感;肺炎克雷伯菌对氨苄西林、头孢唑啉、头孢吡肟耐药性较高,对阿米卡星较敏感;铜绿假单胞菌对常见抗菌药耐药水平普遍较高,其中对氨苄西林、头孢唑啉耐药性均>90%。结论 革兰阴性菌是导致前列腺癌术后尿路感染的主要病原菌。分离的主要革兰阳性菌对青霉素G、氨苄西林、利福平、哌拉西林耐药水平较高,对万古霉素、利奈唑胺和替加环素较敏感;分离的主要革兰阴性菌对氨苄西林、头孢唑啉耐药水平较高。Objective To identify the species of pathogens causing urinary tract infections among prostate cancer patients following surgical treatment,and to test the susceptibility of bacterial isolates to common antimicrobial agents.Methods Prostate cancer patients undergoing surgical treatment and developing urinary tract infections post-surgery during the period from February 2020 to February 2024 were recruited.Urine samples were collected under sterile conditions,and the pathogen species were characterized using the XD200 fully automated rapid microbial culture and identification system.In addition,the susceptibility of major bacterial isolates to common antimicrobial agents was tested using the K-B disk diffusion test.Results A total of 14l pathogens were isolated from 107 urine samples collected from prostate cancer patients with urinary tract infections following surgical treatment,and the proportions of Gram-negative bacteria,Gram-positive bacteria and fungi were 63.83%,29.08%and 7.09%,respectively.Enterococcus faecalis and E.faecium were dominant Gram-positive bacterial isolates(10.64% each of all pathogens),and Escherichia coli,Klebsiella pneumonia and Pseudomonas aeruginosa were dominant Gram-negative bacterial isolates.E.faecalis,E.faecium and Staphylococcus aureus were 100.00%resistant to penicillin G,and 100.00%susceptible to vancomycin,linazolamide and tigecycline.E.faecalis showed a high-level resistance to ampicillin(97.25%),and E.faecium showed a high-level resistance to rifampicin(88.20%),while S.aureus was 100.00%resistant to tobramycin and showed a high-level resistance to rifampicin(90.23%)and ampicillin(87.21%).E.coli showed a high-level resistance to ampicillin,cefoperazone and ampicillin/sulbactam,and a high susceptibility to imipenem and amikacin,and K.pneumonia showed a high-level resistance to ampicillin,cefoperazone and cefepime and a high susceptibility to amikacin,while P.aeruginosa showed a high-level resistance to common antimicrobial agents,with>90%prevalence of resistance to ampicillin a

关 键 词：致病菌 耐药性 尿路感染 前列腺切除术 

分 类 号：R446.5[医药卫生—诊断学] R737.25[医药卫生—临床医学]