189例宫颈癌患者术后导尿细菌培养及药敏结果分析

Analysis of Pathogenic Organisms and their Antimicrobial Susceptibility of 189 Patients having Cervical Carcinoma with Postoperative Urethral Catheterization

目的：了解宫颈癌患者术后导尿细菌培养病原菌种类及其对抗生素的耐药性。方法：对我院2006年1月至2008年1月189例宫颈癌术后患者,留置导管5~7天后的留置导尿细菌培养及药敏结果进行回顾性分析。结果：189份导尿标本中尿培养阳性87份,阳性率为46.0%,其中临床无症状或者尿常规白细胞〈5/HPF的有37例,占尿培养阳性患者的42.5%。189份导尿标本中诊断尿路感染的共50例,发生率为26.5%。尿培养共检出病原菌95株,检出率居前的分别是热带假丝酵母菌29.5%（28/95）,大肠埃希菌16.8%（16/95）,阴沟肠杆菌14.7%（14/95）,粪肠球菌8.4%（8/95）。另外在87份尿培养阳性标本中,混合感染（由两种或三种菌）占8.1%（7/87）,酵母菌的检出率占阳性标本的41.4%（36/87）。药敏结果提示除酵母菌外的大多数病原菌呈多重耐药性。结论：宫颈癌术后导尿患者,尿培养以假丝酵母菌检出率最高,其次为大肠埃希菌、阴沟肠杆菌、粪肠球菌。预防性使用抗生素不能降低尿路感染的发生率,加强护理、及早拔管对控制宫颈癌术后泌尿系统感染和减少耐药菌的产生十分重要。

Objective：To investigate the strains of pathogenic organisms and the drug resistance to antibiotic of the patients with postoperative urethral catheterization in cervical carcinoma.Methods：One-hundred and eighty-nine patients with postoperative urethral catheterization in cervical carcinoma were analysed from January 2006 to January 2008.Results：Among 189 urine aliquot,87 were positive（46.0%）,37 no clinical symptom or 〈5/HPF in urine（42.5%）,and 50（26.5%）diagnosed urinary tract infection.Ninty-five strains were isolated,in the most common pathogens,29.5%（28/95）were Candida tropicalis,16.8%（16/95）were Escherichia coli,14.7%（14/95）were Enterbacter cloacae,and 8.4%（8/95）were Enterococcus faecalis.In the positive specimen,8.1%（7/87）were combined infection（infected by 2 or 3 organisms）,and candida species positive detection rate was 41.1%.Most strains were multi-drug resistant exapt the Candida species.Conclusion：The most common pathogens of patients with postoperative urethral catheterization in cervical caricinoma were Candida tropicalis,followed by Escherichia coli、Enterbacter cloacae、and Enterococcus faecalis.Elaborative attendance was most important and application prophylaxis of antibiotics was ineffective for the of patients contacting urinary infection and reducing the development of resistant strains.