摘要
目的探讨分析复发性尿路感染的细菌检验结果及其药敏情况,为临床合理用药提供参考依据。方法选取2015年11月~2017年11月我院收治的138例复发性尿路感染患者作为研究对象,采集患者的中段尿液标本进行培养,检测尿液样本中的细菌种类并对其实施药敏试验,对细菌检验结果以及其敏感性进行统计分析。结果通过尿液标本细菌检验,138例患者共检测出124株细菌,其中革兰阳性球菌40例,占比32.26%,革兰阴性杆菌84例,占比67.74%。药敏试验显示肠球菌属、链球菌属、金黄色葡萄球菌属等革兰阳性球菌对氨苄西林的、红霉素、克林霉素、阿米卡星、利福平、环丙沙星、头孢吡肟的耐药性较高,而对替考拉宁、万古霉素的耐药性则非常低,对其他类型药物的敏感度则表现为中等水平。大肠埃希菌、阴沟肠杆菌、铜绿假单胞菌以及克雷伯菌属等革兰阴性杆菌对氨苄西林、头孢唑啉、阿莫西林/克拉维酸、哌拉西林以及四环素、氯霉素等药物的耐药性比较高,对三代头孢菌素头孢噻肟、四代头孢菌素头孢吡肟、左旋氧氟沙星、环丙沙星敏感度等药物表现中等,而对阿米卡星、美洛培南、亚胺培南的敏感性比较高。结论诱发复发性尿路感染的致病菌以革兰阴性杆菌为主,而不同种类的致病菌对于不同的抗生素的敏感性也存在较大的差别,因此在临床治疗过程中,要结合细菌检测和药物敏感性检测两方面的结果进行指导用药,以提高临床疗效。
Objective To explore the flora distribution and drug sensitivity in patients with recurrent urinary tract infection,and to provide reference for clinical rational drug use.Methods From November 2015 to November 2017,138 cases of recurrent urinary tract infection in our hospital were selected as the research subjects.The urine samples from the middle part of the patients were collected for culture,and the bacterial species in the urine samples were detected and tested for drug sensitivity.The results of bacteria and its sensitivity were statistically analyzed.Results A total of 124 strains of bacteria were detected in 138 patients,40 of which were Gram-positive cocci,accounting for 32.26%and 84 cases were Gram-negative bacilli,accounting for 67.74%.Drug sensitivity test showed that Enterococcus,Streptococcus,Staphylococcus aureus and other Gram-positive cocci were highly resistant toampicillin,erythromycin,clindamycin,amikacin,rifampicin,ciprofloxacin and cefepime,but very lowly resistant to teicoplanin,vancomycin,while the sensitivity of other drugs was moderate.Escherichia coli,Enterobacter cloacae,Pseudomonas aeruginosa,Klebsiella and other gram-negative bacilli were highly resistant to ampicillin,cefazolin,amoxicillin/clavulanic acid,piperacillin and tetracycline,chloramphenicol.For the third generation cephalosporin cefotaxime,the fourth generation cephalosporin cefepime,levofloxacin,ciprofloxacin and other drugs showed moderate sensitivity.But the sensitivity of those to amikacin,meropenem and imipenem was wery higher.Conclusion Gram-negative bacilli are the main pathogenic bacteria to induce recurrent urinary tract infection,and the sensitivity of different kinds of pathogens to different antibiotics is different,so in the course of clinical treatment.In order to improve the clinical efficacy,we should combine the results of bacterial detection and drug sensitivity test to guide the use of drugs.
作者
刘典浪
甘峰
黄玉佳
高丹
LIU Dianlang;GAN feng;HUANG Yujia;GAO Dan(Department of Laboratory,Fuyong People's Hospital of Baoan District,Shenzhen 518103,China)
出处
《中国医药科学》
2018年第13期123-126,共4页
China Medicine And Pharmacy
关键词
复发性尿路感染
细菌检验
药敏实验
敏感性
Recurrent urinary tract infection
Bacterial examination
Drug susceptibility test
Sensitivity
