189例男性尿路感染临床分析

Clinical analysis in 189 male patients with urinary tract infections

目的探讨男性尿路感染的易感因素,致病菌的分布及其耐药情况,为临床治疗提供依据。方法对189例尿培养阳性的男性尿路感染患者的易感因素、尿培养及其药敏试验结果进行回顾性分析。结果189例男性尿路感染患者,复杂性尿感占87．83%。易感因素以留置尿管、前列腺疾病、尿路结石为主。205株致病菌中革兰氏阴性杆菌占61．95%。其中大肠杆菌占30．73%；革兰氏阳性球菌占17．07%；真菌占20．98%。从药敏试验得出,所有菌株耐药率最低的是亚胺培南,其次为阿米卡星、哌拉西林/他唑巴坦。肠球菌对氨苄西林有中度敏感性,重症肠球菌感染可首选万古霉素。有尿路操作者真菌和变形杆菌感染率明显高于无尿路操作者(P＜0．01)。结论男性尿路感染以复杂性尿感为主,主要致病药仍是革兰氏阴性杆菌,并以大肠杆菌为主,真菌感染有上升趋势,临床中应引起重视。

Objective To investigate predisposing factor, the bacterial profile and pattern of drug resistance of pathogenic bacteria of urinary tract infection （UTIs） in male patient and to determine its clinical impact on management, Methods Distribution and antibiotics sensitivity test of pathogens in 189 cases of male urinary tract infection were retrospectively analyzed, Results Complicated UTIs accounted for 87.83% in male patients, predisposing factors included indwelling catheter, prostate disease and lithangiuria, The rate of Gram-negative bacteria in 205 strains of pathogenic bacteria was 61.95%, including 30.73% of E. Coli Gram-positive Cocci was 17.07% and fungi 20.98%. The antibiotic resistance rate of imipenen was the lower. Second were amikacin and piperacillin/tazobactam. Enterococcus to ampicillin was mediate sensitive and vancomycin is the first choice to treat severe infection with enterococcus. The incidence of fungi and Proteus SPP infection were higher in those with urinary tract operation than those without operation （P〈0.01）. Conclusion Male UTIs are of complicated characteristic, the main pathogenic bacteria are Gram-negative bacilli,. E, coli is the most frequency isolated. Fungi is being obtained with increasing frequency.