摘要
目的 探讨泌尿道反复感染致病菌的发病特点、临床特征及其耐药性。 方法 将 138例患者的无菌中段尿进行常规 (沙氏培养基 )和高渗培养基同步培养 ,并用 K- B法进行药物敏感试验 (简称药敏 )。 结果 高渗培养的阳性率占 5 1% (71/ 138) ,明显高于沙氏培养 2 1% (2 9/ 138)的阳性率。药敏结果显示 :L型 (含伴 L 型 )细菌对作用于细胞壁的抗生素不敏感 ,耐药率达 73%左右 ,如 PNC等药物 ;对作用于细胞膜、蛋白质或者核酸的抗生素敏感 ,耐药率为 5 %左右 ,如丁胺卡那霉素等药物。 结论 L型细菌 (含伴 L型 )在泌尿道感染反复发作的过程中占主要地位 ,因其临床表现不典型 ,容易导致漏诊或误诊 ,以致耐药性的形成 ,建议在临床选用药物治疗的过程中应兼顾 L 型和细菌型 ,以利合理用药 。
Objective Discuss the clinical peculiarity and drug resistance of the pathogen of recurrent urinary tract infection. Methods Synchronal culture of 138 bacteria-free middle section urine samples in Sabourand medium and L medium, and K-B drug-sensitivity test is conducted. Result The positive rate of L medium (51%) is obviously higher than Sabourand medium (21%). The results of drug-sensitivity test indicate that L-bacteria(including accompanied L-bacteria) are not sensitive to the antibiotics that react to cell coat, in which the resistance rate is about 73%, such as PNC; the resistance rate of drug that react to cell membrane,protein or nucleuacid is 5%, such as kanamycin. Conclusion L-bacteria(including accompanied L-bacteria) are the main pathogen in recurrent urinary tract infection. The diagnosis is easy to be omitted or disjudged because of its atypical clinical symptom. All these lead to drug resistance. It is suggested that doctors include L-bacterias as one of the concerns in selecting antibiotics, so as to reduce the recurrence with a rational regimen.
出处
《实用预防医学》
CAS
2003年第4期500-501,共2页
Practical Preventive Medicine
关键词
尿路感染
复发
尿标本
L型细菌
药敏试验
urinary tract infection
recurrence
urine sample
L-bacteria
drug-sensitivity test
