老年人尿路感染病原菌的分布及耐药性分析

目的 了解老年人尿路感染病原菌的分布及耐药性,为临床的诊断及合理使用抗生素治疗提供可靠的依据.方法 采用纸片扩散法(K-B法)对住院的老年患者尿培养分离出的651株细菌进行鉴定和耐药性分析.结果 住院老年人尿路感染菌株以大肠埃希菌为主,占43.9%;其次为肠球菌属(20.1%)、肺炎克雷伯菌(10.4%)、凝固酶阴性葡萄球菌(8.1%)以及阴沟肠杆菌、铜绿假单胞菌、金黄色葡萄球菌和真菌.产ESBLs细菌的检出率为48.3%;MRS株为56.7%.肠杆菌科细菌除对亚胺培南保持高敏感外,对其他抗生素耐药率均呈上升趋势;革兰阳性球菌耐药率为普遍较高,仅对万古霉素仍保持较高敏感.结论 肠杆菌科细菌和肠球菌属细菌分别占尿路感染病原菌的前两位;由于病原菌耐药性呈上升趋势,临床医师应结合尿培养和药敏试验的报告结果,合理选用抗生素.

Analysis on the distribution and drug resistance of pathogenic bacteria in urinary tract infection from elderly patients

Objective To provide reliable evidence for diagnosis and treatment of urinary tract infection from elderly patients based on understanding the distribution and drug resistance of pathogenic bacteria.Methods 651 strains of bacteria isolated from urine culture of the elderly patients were identified and their drug resistances were analyzed.K-B method was used for some special strains,such as MRS and that producing ESBLs.Results The most mainly pathogenic bacteria in urinary tract infection are E.coli,which account for 43.9%.Then they are Enterococcus(20.1%),K.pneumoniae(10.4%),Staphylococcus(8.1%),Enterobacter cloacae,Pseudomonas aeruginosa,Staphylococcus aureus and fungi.The detection rates of the producing ESBLs,and MRS were 48.3%,56.7% respectively.The drug resistances of Enterobacteriaceae for antibiotics were all elevated,except that for imipenem.The drug resistances of gram positive coccus are generally very high,but they were responsive to van-comycin.Conclusion Enterobacteriaceae and Enterococcus were the two most mainly pathogenic bacteria in urinary tract infection.Owing to the elevating drug resistance, doctors should choose antibiotics carefully according to the results of urine culture and drug sensitivity test.