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目的探讨原发性肾病综合征患者尿路感染的病原菌分布及耐药性,为临床合理应用抗菌药物提供理论依据。方法选取医院2010年1月-2015年3月原发性肾病综合征尿路感染患者240例,采集患者尿液样本进行尿液细菌培养,对阳性尿液进行病菌鉴定和耐药性分析。结果 240份尿液样本中有53份培养阳性,阳性率为22.08%;共培养出病原菌53株,其中革兰阴性菌43株占81.13%,革兰阳性菌7株占13.21%,真菌3株占5.66%;大肠埃希菌对氨苄西林耐药率最高,为81.82%,而对亚胺培南耐药率最低,为9.09%;变形菌属对氨苄西林耐药率最高,为60.00%,而对头孢唑林耐药率最低,均为0;阴沟杆菌对头孢他定耐药率最高,为75.00%,而对左氧氟沙星耐药率最低,为0;表皮葡萄球菌对庆大霉素的耐药率最高,为100.00%,而对舒巴坦耐药率最低,为0;链球菌属对头孢他定耐药率最高,为50.00%,对氨苄西林耐药性最低,为0;肠球菌属环丙沙星的耐药性最高,为100.00%,而对氨苄西林耐药性最低为0。结论原发性肾病综合征患者尿路感染的病原菌主要为革兰阴性菌,大肠埃希菌感染居多,病原菌对各类抗菌药物的耐药性有差异,治疗以亚胺培南为首选。
Objective To investigate the distribution and drug resistance of pathogens in urinary tract infection in patients with primary nephrotic syndrome and to provide a theoretical basis for rational use of antibacterials in clinical practice. Methods From January 2010 to March 2015 in our hospital, 240 patients with urinary tract infection of primary nephrotic syndrome were selected. Urine samples of patients were collected for bacterial culture in urine and pathogenic bacteria were identified and drug resistance analysis of positive urine. Results Of 240 urine samples, 53 were positive for culture, with a positive rate of 22.08%. 53 strains of pathogens were co-cultivated, of which 43 strains of Gram-negative bacteria accounted for 81.13%, 7 strains of Gram-positive bacteria accounted for 13.21%, 3 strains of fungi Accounting for 5.66%. Escherichia coli had the highest resistance rate to ampicillin, which was 81.82%, while the lowest resistance rate to imipenem was 9.09%. The resistant rates of ampicillin to ampicillin were the highest (60.00%), While the cefazolin resistance rate was the lowest, were 0; the highest resistance rate of cloacae to ceftazidime was 75.00%, while the lowest rate of levofloxacin, 0; Staphylococcus epidermidis resistant to gentamicin The highest rate was 100.00% and the lowest rate was 0 for sulbactam. The highest rate of ceftazidime was 50.00% for Streptococcus and 0 for ampicillin, Ciprofloxacin is the most resistant, 100.00%, while the lowest resistance to ampicillin 0. Conclusions The pathogens of urinary tract infection in patients with primary nephrotic syndrome are mainly Gram-negative bacteria. Most of them are Escherichia coli, and the pathogenic bacteria have different resistance to various antibiotics. Imipenem is the first choice of treatment.