尿路感染老年患者的病原菌分布及耐药分析

目的 分析老年人尿路感染病原菌分布及其耐药性,指导临床合理用药.方法 采用Vitek-Ams细菌鉴定系统和K-B法分别对339株病原菌进行细菌鉴定和药敏实验,并对革兰阴性杆菌进行超广谱β-内酰胺酶(ESBLs)检测.结果 老年人尿路感染病原菌以革兰阴性杆菌为主(212株),占62.5%,其中占前三位的是大肠埃希菌(38.6%)、肺炎克雷伯菌(6.8%)、变形杆菌属(6.0%)、产ESBLs大肠埃希菌的检出率为36.6%.检出革兰阳性球菌79株(23.3%),其中主要为肠球菌属(16.6%).此外,真菌占14.2%.药敏实验显示革兰阴性杆菌中,亚胺培南耐药率最低,革兰阳性球菌中未发现耐万古霉素菌株.结论 老年人尿路感染病原菌耐药性严重,持续性耐药监测对抗生素的合理应用,提高疗效,减缓耐药菌株的发生与发展有重要意义.

Distribution and drug resistance analysis of pathogens in elderly patients with urinary infection

Objective To analyse the distribution and drug resistance characteristic of pathogens in elderly patients with urinary infection,and guide clinical rational drug use.Methods Vitek-Ams system and Kirby-Bauer method were used for bacteria identification and drug sensitive test of 339 strains,respectively.In addition,ESBLs-producing Gram negative bacteria were detected.Results Among 339 strains from elderly patients with urinary infection,Gram negative bacteria rated to the top one(212 strains,62.5%).The most common pathogens were Escherichia coli(38.6%),Klebsiella pneumoniae(6.8%),and Bacillus proteus(6.0%).36.6% of Escherichia coli produced ESBLs.The rate of Gram positive bacteria account was 23.3%.Enterococcus played the most important role(19.2%),the second was Fungi(14.2%).The results of drug sensitive test showed that drug resistance rate of imipenem was the lowest among Gram negative bacteria.There was no vancomycin resistance strain among Gram positive bacteria.Conclusion The drug resistance of pathogens is serious in elderly patients with urinary infection.Continuous monitoring of drug resistance plays an important role in the rational use of antibiotics,enhancement of therapeutic effect,and reduction of drug resistance strains.