摘要
目的分析血清降钙素原(PCT)和尿液内毒素水平对留置导尿管伴随性感染(CAUTI)治疗的指导作用。方法选取180例确诊为CAUTI的患者,根据血清PCT和尿液内毒素水平决定是否使用抗菌药物及抗菌药物种类。将180例患者分为不使用抗菌药物组(60例)、抗革兰阴性(G^-)菌抗菌药物组(60例)和抗革兰阳性(G^+)菌抗菌药物组(60例)。比较3组治疗前后细菌检出及耐药情况、院内感染和治疗情况、相关检验指标、尿路刺激征发生情况的差异。结果抗G^-菌抗菌药物组、抗G+菌抗菌药物组的抗菌药物使用时间、抗菌药物累积用量、院内感染控制时间和住院时间均显著高于不使用抗菌药物组(P<0.001)。3组之间不同细菌的检出率及CAUTI相关检验指标差异均无统计学意义(P>0.05)。抗G^-菌抗菌药物组和抗G^+菌抗菌药物组治疗后不同细菌耐药株的检出率均低于不使用抗菌药物组(P<0.05)。3组治疗后尿路刺激征各项指标(尿频、尿急和尿痛)差异均无统计学意义(P>0.05)。结论血清PCT结合尿液内毒素检测可用于指导CAUTI患者的经验用药。
Objective To analyze the roles of serum procalcitonin(PCT) and urine endotoxin determinations for guiding catheter-associated urinary tract infection(CAUTI) antimicrobial therapy. Methods Totally,180 patients with CAUTI were enrolled and classified into 3 groups,including no drug usage group(60 cases),Gram negative(G^-) bacterial antimicrobial group(60 cases) and Gram positive(G^+) bacterial antimicrobial group(60 cases),according to the situation of antimicrobial therapy based on serum PCT and urine endotoxin levels. The bacterial determination,drug resistance,nosocomial infection and treatment,biochemical indicators and urinary tract irritation in the 3 groups before and after treatment were compared. Results The drug usage time,dosage,nosocomial infection control time and hospital staying time in G^-bacterial antimicrobial group and G^+ bacterial antimicrobial group were higher than those in no drug usage group(P<0.001). The bacterial determination rate and CAUTI-related indicators had no statistical significance among the 3 groups(P>0.05). After treatment,the determination rates for resistant isolates in G^-bacterial antimicrobial group and G^+ bacterial antimicrobial group were lower than those in no drug usage group(P<0.05). Urinary tract irritation indicators,frequent micturition,urgent urination and dysuria,after treatment among the 3 groups had no statistical significance(P>0.05). Conclusions PCT combined with urine endotoxin determination can guide the rational drug usage for CAUTI patients.
作者
卢秀芬
贺志军
刘绮婷
冯仲信
马胜
LU Xiufen;HE Zhijun;LIU Qiting;FENG Zhongxin;MA Sheng(Department of Infectious Diseases,Leliu Hospital of Shunde District of Foshan City,Foshan 528322,Guangdong,China;Department of Clinical Laboratory,Shunde Hospital,Southern Medical University,Foshan 528300,Guangdong,China;Department of Urology,Leliu Hospital of Shunde District of Foshan City,Foshan 528322,Guangdong,China;Department of Clinical Laboratory,Leliu Hospital of Shunde District of Foshan City,Foshan 528322,Guangdong,China)
出处
《检验医学》
CAS
2020年第7期686-690,共5页
Laboratory Medicine
基金
佛山市卫生和计划生育局医学科研课题(20160283)。
关键词
降钙素原
内毒素
导尿管
尿路感染
抗菌药物
Procalcitonin
Endotoxin
Catheter
Urinary tract infection
Antibiotic
