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目的探讨原发性肾病综合征(PNS)患者尿路感染的临床特征、病原菌分布及耐药性。方法选取医院2014年4月-2017年4月收治的375例PNS,根据是否发生尿路感染分为感染组和非感染组,分析感染患者病原菌分布及耐药性,以及发生感染的临床特征。结果 375例PNS患者共发生67例尿路感染,感染率17.87%;共分离83株病原菌,其中革兰阴性菌67株,占80.72%,革兰阳性菌11株,占13.25%,真菌5株,占6.03%;大肠埃希菌对氨苄西林耐药率最高为82.86%,对亚胺培南耐药率最低为5.71%;肺炎克雷伯菌对氨苄西林耐药率最高为75.00%,对亚胺培南耐药率最低;表皮葡萄球菌对庆大霉素的耐药率最高为100.00%,对左氧氟沙星和头孢哌酮耐药性最低为0;感染组患者的24h尿蛋白定量、尿素氮、血肌酐明显高于非感染组,住院时间长于非感染组,而血清白蛋白及IgG水平明显低于非感染组。结论应根据感染的临床特征及病原菌耐药性,合理选择抗菌药物。
Objective To investigate the clinical characteristics, pathogens distribution and drug resistance of urinary tract infection in patients with primary nephrotic syndrome (PNS). Methods 375 cases of PNS admitted from April 2014 to April 2017 in our hospital were divided into infected group and non-infected group according to whether there was any urinary tract infection. The distribution of pathogens, drug resistance and the clinical features of infection were analyzed. Results There were 67 urinary tract infections in 375 PNS patients with infection rate of 17.87%. A total of 83 pathogens were isolated, of which 67 were gram-negative bacteria, accounting for 80.72%, 11 were gram-positive bacteria, accounting for 13.25% , Accounting for 6.03%. The resistant rate of Escherichia coli to ampicillin was 82.86%, and the lowest rate of resistance to imipenem was 5.71%. The highest rate of resistant to ampicillin of Klebsiella pneumoniae was 75.00% The resistance rate of metsperidine was the lowest; the highest rate of resistance to gentamycin was 100.00%, the lowest resistance rate to levofloxacin and cefoperazone was 0; the amount of 24h urinary protein, urea nitrogen , Serum creatinine was significantly higher than non-infected group, hospital stay longer than non-infected group, and serum albumin and IgG levels were significantly lower than non-infected group. Conclusion According to the clinical characteristics of infection and pathogen resistance, rational choice of antimicrobial agents.