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目的 探讨尿路感染的病原种类及耐药性,提高尿路感染的临床诊治水平.方法 分析了2 30例尿路感染患者临床资料、菌种及耐药资料.结果 ①清洁中段尿培养阳性率低(36 .5 % ) .②尿路感染病原菌分布占前几位的细菌分别是大肠埃希菌(5 0 .6 % ) ,变形杆菌(15 .6 % ) ,肺炎克雷伯菌(12 .2 % ) ,肠球菌(12 .1% ) ,假单胞菌(6 .5 % ) ;产超广谱β-内酰胺酶(ESBLs)大肠埃希菌检出率13.6 % ,产ESBLs肺炎克雷伯菌的检出率是18.2 % .③G-杆菌对复方新诺明、氨苄西林、环丙沙星耐药率较高,对亚胺培南、头孢三嗪耐药率低;G+ 球菌对红霉素、青霉素耐药性高,万古霉素耐药性最低;产ESBLs大肠埃希菌及肺炎克雷伯菌对氨基糖甙类、第三代头孢菌素、氨苄西林耐药性较高,而对亚胺培南及酶抑制剂的复方制剂敏感.④尿路感染常规治疗后尿菌检出率为15 .4 % .结论 临床上要重视尿路感染的病原菌药敏检测,经验一线选药广泛耐药,合理使用抗生素,对预防产ESBLs细菌的产生,提高尿路感染治愈率十分重要.
Objective To investigate the pathogen types and drug resistance of urinary tract infection and to improve the clinical diagnosis and treatment of urinary tract infection.Methods Clinical data, bacteria strains and drug resistance data were analyzed in 230 cases of urinary tract infection.Results ① The positive rate of urine culture (36.5%) .②The pathogen distribution of urinary tract infection accounted for the top few bacteria were Escherichia coli (50.6%), Proteus (15.6%), Klebsiella pneumoniae (12 (12.1%) and Pseudomonas (6.5%). The detection rate of Escherichia coli producing extended-spectrum β-lactamases (ESBLs) was 13.6% The detection rate of Klebsiella was 18.2% .③The antibacterial rate of G-bacilli to cotrimoxazole, ampicillin and ciprofloxacin was high, and the resistance rate to imipenem and ceftriaxone was low. The resistance to erythromycin and penicillin was the highest, while the vancomycin resistance was the lowest. ESBLs-producing Escherichia coli and Klebsiella pneumoniae were more resistant to aminoglycosides, the third generation cephalosporins and ampicillin High, and sensitive to imipenem and enzyme inhibitor compound prescription.④The detection rate of urinary bacteria after routine treatment of urinary tract infection was 15.4% .Conclusion Clinicians should pay more attention to urinary tract infection Bacteria susceptibility testing, experience first-line drug selection XDR, rational use of antibiotics to prevent the generation of ESBLs-producing bacteria, urinary tract infections increase the cure rate is very important.