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尿路感染疑似患者的中段尿样本培养病原菌分布情况及耐药性分析 被引量:7

Distribution of pathogenic bacteria and drug resistance in middle urinary sample culture in patients suspected with urinary tract infection
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摘要 目的探究尿路感染疑似患者的中段尿样本培养病原菌分布情况及耐药性。方法于2017年3月至2020年3月在滨州市中心医院检验科抽取的2300例尿路感染疑似患者中段尿样本,采取VITEK-2compact全自动微生物检测系统进行病原菌分布检测,采取纸片扩散形式对药敏进行试验,对病原菌分布以及耐药性实施回顾性探究。结果2300例尿路感染疑似患者的中段尿样本中,检测出病原菌感染690例,阳性率为30.00%;检出920株病原菌,其中革兰阴性菌651株(70.77%),革兰阳性菌231株(25.11%),真菌38株(4.13%)。检出病原菌的中段尿标本以泌尿外科、肾内科以及重症病房为主,分别为38.99%(269/690)、22.61%(156/690)、14.20%(98/690)。主要革兰阴性菌对氨苄西林、哌拉西林、环丙沙星、左氧氟沙星、磺胺甲恶唑/甲氧苄啶、头孢噻肟的耐药性高,对阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药性低;革兰阳性菌对红霉素、四环素、庆大霉素、链菌素的耐药性高,对呋喃妥因、替考拉宁、氯霉素的耐药性低。结论疑似尿路感染患者中段尿样本当中的病原菌主要以大肠埃希菌和铜绿假单胞菌等革兰阴性菌为主,病原菌的耐药性比较高,临床的主治医师应高度关注患者中段尿样本当中的病原学检测结果,按照药敏检测结果来选择敏感性抗菌药物,尽可能降低病原菌耐药情况发生。 Objective To explore the distribution of pathogenic bacteria and their drug resistance in the urine samples of patients suspected with urinary tract infection.Methods Two thousand and three hundred mid-section urine samples of the patients suspected with urinary tract infection from our hospital's laboratory from March 2017 to March 2020 were selected.The VITEK-2 compact automatic microbial detection system was used to detect the distribution of pathogens,and the paper spreading drug susceptibility test was conducted.The distribution of pathogenic bacteria and drug resistance were retrospectively explored.Results A total of 690 samples were detected with pathogens,and the positive rate was 30.00%;920 strains of pathogens were detected;among them,there were 651 strains(70.77%)of Gram-negative bacteria,231 strains(25.11%)of Gram-positive bacteria,and 38 strains(4.13%)of fungi.The mid-section urine samples of pathogenic bacteria were mainly from the urology department[38.99%(269/690)],nephrology department[22.61%(156/690)],and intensive care unit[14.20%(98/690)].The main Gram-negative bacteria were more resistant to ampicillin,piperacillin,ciprofloxacin,levofloxacin,sulfamethoxazole/trimethoprim,and cefotaxime than to amikacin,cefoperazone/subactam,and piperacillin/tazobactam.The Gram-positive bacteria were more resistant to erythromycin,tetracycline,gentamicin,and streptomycin than to furantoin,teicoplanin,and chloramphenicol.Conclusion The pathogenic bacteria in the urine samples of patients suspected with urinary tract infection are mainly Gram-negative bacteria,such as Escherichia coli and Pseudomonas aeruginosa.The pathogenic bacteria have high drug resistance.Clinical attending physicians should choose drugs according to the patients'pathogenic test results to minimize the occurrence of pathogenic bacteria resistance.
作者 赵新惠 樊学英 劳海黎 王建 张国翠 Zhao Xinhui;Fan Xueying;Lao Haili;Wang Jian;Zhang Guocui(Binzhou Central Hospital,Binzhou 251700,China)
出处 《国际医药卫生导报》 2021年第15期2380-2383,共4页 International Medicine and Health Guidance News
关键词 尿路感染 中段尿 样本培养 病原菌分布 耐药性 Urinary tract infection Midstream urine Sample culture Pathogen distribution Drug resistance
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