武汉地区老年患者常见致病菌及其耐药性监测

为了解医院细菌耐药性 ,采用 17种抗菌药纸片 ,K- B琼脂扩散法对武汉地区 13所大中型医院 6 0岁以上住院患者分离出的致病菌进行耐药性监测 ,结果显示 992株细菌中 2 12株 (2 1.37% )为革兰阳性球菌 ,780株 (78.6 2 % )为革兰阴性杆菌。金葡菌中 42 .86 % (5 4/ 12 6 )耐苯唑西林且呈多重耐药 ,对 89%抗生素耐药 ,对万古霉素均敏感。革兰阴性杆菌中检出绿脓杆菌 197株(2 5 .2 6 % ) ,对亚胺配南、环丙沙星、头孢他啶及阿米卡星耐药率在 10 %以下。大肠杆菌对环丙沙星耐药率高达 6 1% ,17种抗菌药对 992株革兰阳性球菌及革兰阴性杆菌抗菌活性最强者依次为亚胺配南、阿米卡星、头孢他啶、头孢哌酮。     

单纯尿路感染致病菌耐药性分析

2002年6月至2004年8月，我们对我院461例单纯尿路感染患者尿液细菌培养和常用抗菌药物敏感试验的结果进行统计分析，旨在指导临床合理用药。     

成人尿路感染病原菌分布及耐药性分析

目的:分析我院成人尿路感染病原菌分布及其耐药性,为合理使用抗菌药物提供依据。方法:收集我院门诊及住院成年患者清洁中段尿标本,从中分离出286株病原菌,对检出病原菌采用纸片扩散法进行鉴定及药物敏感性监测,结果按美国临床和实验室标准协会标准判读。结果:尿路感染以大肠埃希菌检出率最高(66.1%),其次为肠球菌属(5.6%)、铜绿假单胞菌(3.2%)。大肠埃希菌产ESBLs检出率为68.8%。大肠杆菌对喹诺酮类和绝大多数的β-内酰胺类抗生素有较高的耐药性,但对碳青酶烯类药物和含β-内酰胺酶抑制剂的抗生素敏感率仍较高。革兰阳性球菌对替考拉宁敏感性高。结论:大肠埃希菌仍是尿路感染的主要病原菌,病原菌对常用抗菌药物耐药率呈上升趋势,规范合理使用抗菌药物对治疗尿路感染具有重要意义。     

肾病患者尿路感染病原菌的分布及耐药性分析

目的分析肾病患者尿路感染常见的病原菌分布及细菌对抗菌药物的耐药情况。方法收集我院肾病内科2006年9月-2008年9月因肾病住院、合并尿路感染患者尿液标本中分离的病原菌267株,进行细菌鉴定和药敏实验。结果肾病患者合并尿路感染的菌株中以革兰阴性菌为主,尤以大肠埃希菌最为常见,其次为肺炎克雷伯菌;在革兰阳性菌中以肠球菌属为主,真菌感染的数量相对较少。细菌对各种抗菌药物有不同程度的耐药。结论。肾病患者尿路感染的菌株以革兰阴性杆菌为主,耐药率较高。分析病原菌分布及耐药性,对于指导合理选择抗菌药物具有十分重要的临床意义。     

老年败血症患者的致病菌分布及耐药性分析

目的了解老年败血症的病原谱及对抗菌药物的耐药状况。方法收集湖北地区15所大医院所有血和骨髓培养阳性菌共526株,并进行纸片法药敏试验。结果革兰阳性菌和革兰阴性菌分别占42．8％和57．2％。革兰阴性菌中以大肠杆菌占绝对优势(27．0％)。革兰阳性菌中,凝固酶阴性葡萄球菌明显多于金黄色葡萄球菌(分别为21．6％和7．8％)。药敏试验表明老年败血症的病原菌对常用抗菌药物的耐药严重,对革兰阳性菌敏感率80％以上的只有万古霉素和替考拉宁,对革兰阴性敏感率大于80％的只有碳青霉烯类抗生素。结论老年败血症致病菌以革兰阴性菌为主,尤以大肠杆菌常见,机会致病菌感染比例增高;致病菌耐药问题严重,及时监测老年致病菌的变迁和耐药发展趋势以指导临床用药至关重要。     

老年患者泌尿道感染菌群分布及耐药性分析

泌尿道感染是一种常见的细菌性感染疾病,在我国的医院感染中,泌尿道感染仅次于肺部感染,位于第2位.探讨泌尿道感染这类的文献屡见不鲜,而缺乏针对老年人群的泌尿道感染病原菌特征及耐药性分析的报道.为此,本文回顾性分析5年来本院老年住院患者清洁中段尿培养和抗菌药物敏感试验结果,旨在了解老年患者泌尿道感染病原菌菌群分布及耐药特征,从而更好地指导临床经验用药.     

老年肺炎患者致病菌的分布及耐药分析

目的探讨老年肺炎致病菌的分布及耐药情况,为合理应用抗生素提供依据。方法以住院老年肺炎患者200例为研究对象。采集患者晨起漱口后用力咳出的呼吸道深部痰进行致病菌的培养和分离,运用纸片扩散法进行药敏试验。结果共检出137株致病菌。铜绿假单胞菌占21.90%,对氨苄西林、头孢曲松、头孢唑林、头孢噻肟的耐药率超过85%。金黄色葡萄球菌占18.98%,对环丙沙星、头孢唑林、磺胺甲噁唑、青霉素和苯唑西林等药物的耐药程度高。结论老年肺炎患者致病菌以G-杆菌为主,其中又以铜绿假单胞菌最为常见;致病菌的耐药性有所增加。     

老年患者下呼吸道感染主要病原菌分布及耐药性分析

老年人尤其是老年重症患者,由于基础疾病致脏器功能衰竭、免疫功能降低,成为医院内易感人群.而老年人呼吸道感染是最常见的院内感染,并且呼吸道感染可诱发和加重脏器功能衰竭,促进死亡[1].但由于滥用抗生素或不合理使用抗菌药物,导致耐药病原菌不断增加、病程迁延,产生并发症,甚至治疗失败.本文对我院收治的老年住院患者痰标本进行细菌培养及耐药分析.     

尿路感染患者菌群分布及药敏试验分析

尿路感染是常见的感染性疾病,绝大部分由细菌引起。随着抗生素和免疫抑制剂、激素及介入诊断的广泛应用,细菌感染和耐药逐年上升,患者免疫功能下降,致真菌感染亦日益增多,因此合理应用抗生素是非常必要的。为了配合临床医生及时诊断和治疗,掌握细菌感染的种类及耐药情况,本文收     

760例下呼吸道病原菌分布及耐药性分析

目的观察下呼吸道病原菌分布及耐药性特点。方法我院呼吸科因呼吸道感染住院患者的合格痰、支气管冲洗液标本进行细菌学培养及药物敏感试验。结果 760株细菌中,G-杆菌占53.2%,G+球菌占27.1%,真菌占19.7%;其中G-菌以肺炎克雷伯氏菌(12.1%)、铜绿假单胞菌(7.9%)和大肠埃稀氏菌(7.1%)为主;G+球菌占27.1%,溶血葡萄球菌(8.7%)、黄色葡萄球菌(5.8%)、粪肠球菌(5.3%)为主;真菌以白色念珠菌(13.4%)为主;药敏结果提示亚安培南对G-杆菌作用最强,G+球菌对万古酶素表现为高度敏感,对其他抗菌药物存在不同程度的耐药。结论下呼吸道感染以G-杆菌感染为主,真菌感染率上升,细菌多重耐药性显著,应根据药敏选择抗菌药物。     

下呼吸道感染患者病原菌分布及耐药性变迁

目的了解下呼吸道感染病原菌的分布及耐药性的变化趋势。方法统计2010年医院呼吸内科住院患者痰液培养标本及药敏结果,并与2005年结果比较。结果 2005年,2010年革兰阴性菌分别占当年总菌株数的64.7%和46.7%,革兰阳性菌分别占18.9%和22.2%,真菌分别占16.4%和23.6%。革兰阴性菌以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和不动杆菌为主,铜绿假单胞菌对亚胺培南耐药率有显著上升。革兰阳性菌以金黄色葡萄球菌和表皮葡萄球菌为主,两者对万古霉素敏感,对苯唑西林耐药,真菌以白色假丝酵母菌为主,对氟康唑耐药性增加。结论本组资料对下呼吸道感染的治疗和抗菌药物的选择有参考价值,应重视下呼吸道感染病原菌的变化及耐药性监测,抗菌药物的选择应在体外细菌药敏试验指导下进行。     

肺部感染细菌分布特征及其药敏试验研究

目的 对我院肺部感染患者痰标本所培养的细菌分类及对抗菌药物耐药情况进行调查分析.方法 回顾性分析2008年9月-2011年1月我院收治的肺部感染患者培养出的143株细菌及其耐药性.结果 G-杆菌是主要致病菌,其中铜绿假单胞菌位居第一.G＋球菌中以耐甲氧西林金葡萄球菌（MRSA）为主.分离出的G-杆菌敏感的抗菌药物有亚胺培南、头孢哌酮/舒巴坦等;G＋球菌对万古霉素、替考拉宁敏感.结论 G-杆菌是肺部感染的主要致病菌,耐药率高,应积极预防.     

Pediatric Urinary Tract Infection

Urinary tract infection (UTI) in childhood affects many children but it can be difficult to diagnose, especially in infancy where it is believed that most renal damage occurs. UTI can point the way to underlying congenital abnormalities of the urinary tract which are uncommon, as are the long-term sequelae of renal scarring, hypertension and chronic renal failure. It is now appreciated that many infants have reflux associated damage before birth with associated renal dysplasia. Investigations in children with a UTI remain controversial with ultrasonography being sufficient in experienced hands and only selected patients undergoing cystography and radionuclide imaging. Gross vesicoureteric reflux (VUR) is rare and most mild to moderate VUR resolves spontaneously. Although there is no randomised controlled trial to date low dose prophylactic antibiotics are used in the majority of children in whom VUR is detected with surgery being reserved for those with problematical infections or anatomical abnormalities. Familial reflux is increasingly recognised.     

济宁市某医院呼吸道感染患者病原菌分布及耐药性分析

目的了解济宁市第一人民医院呼吸道感染的病原菌菌群分布及耐药性,为临床治疗提供依据。方法采取生物梅里埃APISystem鉴定和VitekAmSystena微生物自动分析仪进行细菌鉴定,抗生素耐药性分析采用K—B纸片法,20eAUX酵母菌法测定真菌。MIC评价其耐药性。结果从148例呼吸道感染患者留取的痰标本中共分离出菌株120株,病原菌以革兰阴性菌为主,占66．7％,前5位分别为铜绿假单胞、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌及阴沟肠杆菌和嗜麦芽寡养单胞菌;革兰阳性菌占23．3％,主要为金黄色葡萄球菌、肺炎链球菌及粪肠球菌和肺炎链球菌;真菌占10．0％,以白念珠菌为主。大多数革兰阴性菌对头孢哌酮／舒巴坦、左氧氟沙星、亚胺培南的耐药率较低,耐药率为5．8％～33．3％;头孢唑林、头孢曲松、氨苄西林的耐药率较高,耐药率均在50％以上。革兰阳性致病菌对万古霉素较敏感,对其他抗菌药物耐药程度均较低。结论济宁市第一人民医院呼吸道感染的病原菌以革兰阴性杆菌为主,且耐药菌株所占比例较高,应合理地应用抗菌药物。     

呼吸机相关肺炎病原菌及其耐药性

目的 探讨呼吸机相关肺炎(VAP)病原菌及其耐药性。方法 采用回顾调查43例VAP的临床资料、病原菌的构成及其耐药性。结果 3年来VAP的发生率为44．3％，培养出的病原菌98株，77．5％为革兰氏阴性(G^-)杆菌，其中以铜绿假单胞菌、鲍曼氏不动杆菌、大肠埃希氏菌为主，对多种抗生素耐药。18．4％为革兰氏阳性(G )球菌，以金黄色葡萄球菌最为常见；4．1％为真菌，均为白色念珠菌。结论 VAP病原菌以G^-杆菌为主，其对多种抗生素的耐药情况严重。在治疗VAP时应重视病原菌培养和药敏试验的结果，合理应用抗生素。     

Urine Interleukin-8 Is a Marker for Urinary Tract Infection in Postoperative Patients

Background: Urine of patients with urinary tract infection (UTI) contains high levels of interleukin (IL)-6 and IL-8. However, knowledge of the kinetics of their release in urine is limited. We therefore compared the appearance of IL-6 and IL-8 in urine after uncomplicated surgery and surgery complicated by UTI. Patients and Methods: 165 patients undergoing abdominal surgery who received a urinary catheter were studied. Urine IL-6 and IL-8 were prospectively measured in patients who did (n = 10) or did not (n = 20) develop UTI. Statistical analysis was done by one-way ANOVA and the Mann-Whitney test. Results: Although urine IL-6 increased in the 2 to 4 days preceding the bacteriological documentation of UTI, a similar increase was observed in patients who did not develop UTI. Urine IL-8 was elevated on the day UTI was diagnosed, while remaining low in controls. Conclusion: In this patient group with postoperative UTI, urine IL-8 was a better marker for the early host response than urine IL-6. Received: October 5, 2000 · Revision accepted: July 14, 2001     

UTI and Urinary Tract Reconstruction

Reconstruction of the lower urinary tract is necessary after a variety of urological interventions. Radical cystectomy is the mainstay of treatment for muscle-invasive bladder cancer. But also neurogenic bladder dysfunction or other non-malignant diseases may require cystectomy with the need for restoration of the urinary tract. Indications for reconstruction using intestinal segments have expanded greatly. However, bowel was not meant to serve as a conduit or a storage device for urine and its incorporation into the urinary tract may result in numerous complications. Urinary diversions include incontinent stomas, continent urinary reservoirs, and orthotopic bladder substitutes. One of the major goals of urinary diversions is to prevent infectious complications and to preserve the upper urinary tract. Renal function may potentially be at risk from several factors including urinary infection, urinary tract obstruction, ureteric reflux, stone formation, and recurrent tumour formation in case of malignancy. Infections manifest themselves as bacteriuria or as acute or chronic pyelonephritis. The vast majority of conduits and most continent diversions will develop chronic bacteriuria at some stage. In contrast to orthotopic bladder substitutes which remain sterile, particularly if they are free of residual urine. The significance and consequences of bacteriuria and urinary tract infections will be discussed in this section taking into account the most common forms of incontinent, continent and orthotopic urinary diversions.