257例截瘫患者泌尿系感染分离菌种类与耐药分析

Separation pathogenic microorganisms type in the paraplegia patients' urinary system infection and drug resistance analysis

目的：了解截瘫患者泌尿系感染病原菌的现状及对常用抗菌药物的耐药情况，为临床合理选用抗菌药物提供依据。方法：对2003年1月-2006年6月间我院住院及门诊截瘫患者尿培养分离的232株病原菌进行鉴定和体外耐药性监测。结果：革兰阳性菌65株，占27．6％；革兰阴性菌168株，占72．4％。分离率较高的依次为大肠埃希菌、葡萄球菌属、变形杆菌属、枸橼酸杆菌属、肺炎克雷伯菌、肠球菌属、铜绿假单胞菌。体外耐药监测表明，革兰阳性球菌耐药性非常严重，对万古霉素较敏感；革兰阴性杆菌较敏感的药物为亚胺培南、头孢哌酮／舒巴坦、头孢吡肟、氨曲南及阿米卡星。结论：截瘫患者泌尿系感染仍以大肠埃希菌为主，临床医师应根据药敏结果，合理使用抗菌药物以降低耐药性和采取有效措施控制其传播是非常重要的。

Objective： To know the present status and durg resistance of pathogenic micoorganisms in the paraplegia patient＇s urinary system infection. Methods： A total of 232 pathogenic strain in the paraplegia patient＇s urinary system infection from inpatients and outpatients from Jan.2003 to Jun.2006 were identified and the drug resistance test was preformed. Results： Gram positive coccus 65 strairts（27.6%）, Gram negative bacillus 168 strains（72.4 % ）. The separative rate comparatively is high in turn is E. coli, Staphylococcus, Proteus, Citrobacter, K. pneumoniae, Enterococcus, P. aeruginosa. The result of durg resistance suggested that Gram positive coccus were shawed very serious, but still be senstive about vancomycin relatively. Most of Gram negative bacillus were susceptible to imipenem, cefoperazone/sulbactam, cefepime, aztreonam and amikacin. Conclusion： E.coli is still the main infectious bacterium in the paraplegia patients＇ urinary infection. Rational use of antibiotics should be carried out according to urine culture results. It is very important to promote the rational use of antimicrobial agents so that resistance is minimized and take effective containment for the control of the problem.