摘要
目的了解老年男性患者尿标本病原菌分布及耐药性,为其感染治疗提供参考。方法选取2012年1月—2016年12月于无锡市人民医院门诊就诊及住院的老年男性尿路感染患者为研究对象,分析其尿路感染病原菌分布及耐药性。结果共收集尿路感染病原菌2745株,标本阳性率较高的科室是重症监护病房(ICU)、泌尿外科、内分泌科,分别为52.75%、48.70%和43.63%。其中革兰阴性(G-)菌1377株(50.16%),革兰阳性(G+)菌814株(29.65%),真菌554株(20.19%)。检出菌株数居前5位的依次是大肠埃希菌(487株,17.74%)、屎肠球菌(256株,9.33%)、铜绿假单胞菌(253株,9.22%)、白假丝酵母菌(250株,9.11%)及粪肠球菌(216株,7.87%)。泌尿外科检出大肠埃希菌(115株,23.52%)、铜绿假单胞菌(88株,35.06%)和粪肠球菌(77株,35.65%)最多,ICU检出屎肠球菌(38株,14.84%)和白假丝酵母菌(83株,33.20%)最多。大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对亚胺培南的耐药率分别为1.23%、5.59%、15.02%;大肠埃希菌对哌拉西林/他唑巴坦、阿米卡星、呋喃妥因的耐药率分别为3.49%、6.16%、8.62%;肺炎克雷伯菌对头孢吡肟、头孢他啶、哌拉西林/他唑巴坦的耐药率分别为23.78%、16.78%、12.59%。屎肠球菌对万古霉素、利奈唑胺的耐药率分别为4.30%、4.69%;粪肠球菌对万古霉素、利奈唑胺、氨苄西林的耐药率分别为0.46%、2.78%、3.24%。共检出耐碳青霉烯类铜绿假单胞菌38株,检出菌株数呈逐年上升趋势。结论该院老年男性患者尿路感染的主要病原菌为大肠埃希菌,其对亚胺培南、哌拉西林/他唑巴坦、阿米卡星及呋喃妥因较敏感。老年男性患者尿路感染居前五位病原菌科室分布存在差异,临床经验治疗应参考老年男性尿路感染病原菌的科室分布及耐药特点,从而针对性选用抗菌药物。
Objective To understand the distribution and drug resistance of pathogens from urine specimens of older male patients,and provide reference for treatment of infection.Methods Older male outpatients and inpatients with urinary tract infection(UTI)in Wuxi People’s Hospital from January 2012 to December 2016 were selected as the research objects,distribution and drug resistance of pathogens of UTI was analyzed.Results A total of 2745 strains of pathogens were collected,the departments with high positive rate of specimens were intensive care unit(ICU),department of urology,and department of endocrinology,positive rate were 52.75%,48.70%,and 43.63%respectively.1377 strains(50.16%)were Gram-negative bacteria,814 strains(29.65%)were Gram-positive bacteria,and 554 strains(20.19%)were fungi.The top 5 isolated strains were Escherichia coli(E.coli,n=487,17.74%),Enterococcus faecium(E.faecium,n=256,9.33%),Pseudomonas aeruginosa(P.aeruginosa,n=253,9.22%),Candida albicans(C.albicans,n=250,9.11%),and Enterococcus faecalis(E.faecalis,n=216,7.87%).E.coli(n=115,23.52%),P.aeruginosa(n=88,35.06%),and E.faecalis(n=77,35.65%)were the most detected strains in department of urology.E.faecalis(n=38,14.84%)and C.albicans(n=83,33.20%)were the most detected strains in ICU.Resistance rates of E.coli,Klebsiella pneumoniae(K.pneumo-niae),and P.aeruginosa to imipenem were 1.23%,5.59%,and 15.02%respectively;resistance rates of E.coli to piperacillin/tazobactam,amikacin,and furantoin were 3.49%,6.16%,and 8.62%respectively;resistance rates of K.pneumoniae to cefepime,ceftazidime,and piperacillin/tazobactam were 23.78%,16.78%,and 12.59%respectively.Resistance rates of E.faecium to vancomycin and linezolid were 4.30%and 4.69%respectively;resistance rates of E.faecalis to vancomycin,linezolid,and ampicillin were 0.46%,2.78%,and 3.24%respectively.A total of 38 strains of carbapenem-resistant P.aeruginosa were isolated,there was increased trend in the number of strains year by year.Conclusion The main pathogens causing UTI in older male patients is E.coli,which is sensitive to imipenem,piperacillin/tazobactam,amikacin,and furantoin.Distribution of the top 5 pathogens in departments of older male patients with UTI is different,clinical empirical therapy should consider department distribution and antimicrobial resistance characteristics of pathogens of older male patients with UTI,so as to select antimicrobial agents rationally.
作者
吴政龙
张秀红
董亮
耿先龙
WU Zheng-long;ZHANG Xiu-hong;DONG Liang;GENG Xian-long(Department of General Surgery,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Pharmacy,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Intensive Care Unit,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Laboratory Medicine,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2020年第5期411-416,共6页
Chinese Journal of Infection Control
基金
国家自然科学基金(81400054)
无锡市科技发展指导性计划(CSZ0N1604)
无锡市人民医院院内课题(RKB201718)。
关键词
尿路感染
老年男性患者
病原菌
耐药性
urinary tract infection
older male patient
pathogen
drug resistance
作者简介
吴政龙(1979-),男(汉族),湖北省黄石市人,主治医师,主要从事普通外科疾病研究;通信作者:张秀红,E-mail:wxzhxh@sina.com。
