论文部分内容阅读
目的:分析老年脑梗死并发尿道感染的病原菌分布及其耐药性。方法:选取2014年9月-2016年9月于我院治疗的240例老年脑梗死并发尿道感染患者为研究对象,收集患者中段尿标本进行细菌分离培养鉴定,分析病原菌分布情况并测定其耐药性。结果:共检出160株病原菌,其中革兰阴性菌108株,占67.50%,革兰阳性菌43株,占26.88%,真菌9株,占5.63%,前五位病原菌分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、溶血性葡萄球菌及粪肠球菌。在主要革兰阴性菌中,大肠埃希菌对头孢曲松耐药率最高(69.81%),对亚胺培南最敏感(3.77%);铜绿假单胞菌对环氧沙星耐药率最高(88.24%),对头孢曲松、头孢唑啉、头孢他啶、阿米卡星、哌拉西林、亚胺培南最敏感,耐药率均为0.00%;肺炎克雷伯菌对头孢唑林耐药率最高(75.00%),对呋喃妥因最敏感(6.25%)。在主要革兰阳性菌中,金黄色葡萄球菌对红霉素耐药率最高(85.71%);肠球菌属(粪肠球菌及屎肠球菌)对氨苄西林耐药率最高(70.00%);凝固酶阴性葡萄球菌(溶血性葡萄球菌及表皮葡萄球菌)对头孢曲松耐药率最高(93.75%);主要革兰阳性菌对万古霉素、利奈唑胺最敏感,耐药率均为0.00%。结论:老年脑梗死并发尿道感染病原菌种类多,应根据耐药性结果合理选用抗生素。
Objective: To analyze the distribution and drug resistance of pathogens in elderly patients with cerebral infarction complicated by urinary tract infection. Methods: A total of 240 elderly patients with cerebral infarction complicated with urinary tract infection treated in our hospital from September 2014 to September 2016 were enrolled in this study. Urine specimens from the middle of the patients were collected for bacterial isolation and identification. The distribution of pathogens was analyzed and their drug resistance Sex. Results: A total of 160 pathogens were detected, of which 108 strains were Gram-negative bacteria, accounting for 67.50%, 43 Gram-positive bacteria, accounting for 26.88% and 9 strains accounting for 5.63%. The top five pathogens were Escherichia coli Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus haemolyticus and Enterococcus faecalis. Among the major Gram-negative bacteria, Escherichia coli had the highest rate of resistance to ceftriaxone (69.81%), the most sensitive to imipenem (3.77%); the rate of resistance to Pseudomonas aeruginosa (88.24%) were the most sensitive to ceftriaxone, cefazolin, ceftazidime, amikacin, piperacillin and imipenem with the resistance rates of 0.00%. Klebsiella pneumoniae was the most sensitive to cefazolin The highest rate of resistance (75.00%), the most sensitive to nitrofurantoin (6.25%). Among the major Gram-positive bacteria, Staphylococcus aureus had the highest rate of erythromycin resistance (85.71%); Enterococcus (Enterococcus faecalis and Enterococcus faecium) had the highest resistance to ampicillin (70.00%); Staphylococcus aureus (Hemolytic Staphylococcus and Staphylococcus epidermidis) was the most resistant to ceftriaxone (93.75%). The main Gram-positive bacteria were the most sensitive to vancomycin and linezolid, the rates of resistance were 0.00% . Conclusion: There are many pathogens in urinary tract infection in elderly patients with cerebral infarction. Antibiotics should be selected reasonably according to drug resistance results.