论文部分内容阅读
目的结合临床资料及病原菌的药敏检测结果,分析导尿管相关菌尿的病例特点和病原菌耐药情况。方法收集我院2010年至2014年所有住院病人的尿标本分离的非重复细菌1831株进行耐药率分析,通过电子病历系统收集患者资料。结果留置导尿和非留置导尿组中,无症状菌尿分别占55.9%和57.2%,留置导尿管组所有病人均接受了抗菌素治疗。有症状感染的病人合并菌血症的比例明显升高。大肠埃希菌在非尿管来源病原体中占60.1%,在导尿管来源病原体中占35.2%,肠球菌属在导尿管来源病原体中比例为34.9%。尿管来源和非尿管来源的大肠埃希菌对头孢菌素(第2,3,4代)、哌拉西林/他唑巴坦、喹诺酮类和呋喃妥因的耐药率分别为65%~80%和29.4%~68.8%,4.9%~9.8%和2.9%~4.2%,85%~90%和62.7%~77.3%,0~16.7%和7.4%~8.3%。没有发现对利奈唑胺耐药的肠球菌。导尿管来源和非导尿管来源的铜绿假单胞菌对头孢他啶、哌拉西林/他唑巴坦和碳青霉烯类的耐药率分别为11.9%~16.1%和5.7%~7.5%,4.8%~12.5%和2.9%~10.0%,11.9%~21.8%和2.5%~8.6%。而有症状组铜绿假单胞菌的耐药率均低于无症状组,两组耐药率差异5%~15%。结论导尿管相关的无症状菌尿病人仍在临床中接受抗菌素治疗。导尿管来源细菌对抗菌素耐药率高于非尿管来源细菌。
Objective To analyze the characteristics of catheter-related bacteriuria and the drug resistance of pathogenic bacteria based on the clinical data and drug susceptibility test results of pathogenic bacteria. Methods 1831 isolates of non-repetitive bacteria isolated from urine specimens of all inpatients from 2010 to 2014 in our hospital were collected for drug resistance analysis. Patient data were collected by electronic medical record system. Results Asymptomatic bacteriuria accounted for 55.9% and 57.2% respectively in indwelling catheter and non-indwelling catheterization group. All patients in indwelling catheter group received antibiotic treatment. The proportion of patients with symptomatic infection with bacteremia was significantly higher. Escherichia coli accounted for 60.1% of non-catheter-origin pathogens, 35.2% of ureaplasma-derived pathogens, and Enterococci accounted for 34.9% of ureteral-derived pathogens. The drug resistance rates of ureteral-derived and non-ureteral-derived Escherichia coli to cephalosporins (2nd, 3rd, 4th generation), piperacillin / tazobactam, quinolones and nitrofurantoin were 65% ~ 80 % And 29.4% to 68.8%, 4.9% to 9.8% and 2.9% to 4.2%, 85% to 90% and 62.7% to 77.3%, 0 to 16.7% and 7.4% to 8.3%, respectively. No linezolid resistant to linezolid was found. The drug resistance rates of cathepsin and non-catheter-derived Pseudomonas aeruginosa to ceftazidime, piperacillin / tazobactam and carbapenem were 11.9% -16.1% and 5.7% -7.5% respectively, , 4.8% ~ 12.5% and 2.9% ~ 10.0%, 11.9% ~ 21.8% and 2.5% ~ 8.6% respectively. However, the resistant rate of Pseudomonas aeruginosa in the symptomatic group was lower than that in the asymptomatic group, with the difference of 5% -15% in the two groups. Conclusions Catheter-associated asymptomatic bacteriuria is still undergoing antibiotic therapy in the clinic. Catheter-derived bacteria were more resistant to antibiotics than non-duct-derived bacteria.