老年脑血管后遗症患者尿路感染的病原菌及药敏分析

Pathogenic bacteria and antimicrobial susceptibility test in sequelae of cerebrovascular disease associated with urinary tract infections in the aged

目的了解老年脑血管后遗症患者合并尿路感染的病原菌及药敏耐药变化。方法采用Microscan细菌鉴定药敏系统对395例老年脑血管后遗症患者尿标本做细菌培养鉴定和药敏试验。结果老年脑血管后遗症患者尿路感染的病原菌以革兰阴性杆菌为主,占65.33%,并且以大肠埃希菌为最多(占45.34%),病原菌中革兰阳性球菌以凝固酶阴性葡萄球菌和肠球菌为主,药物敏感率较高的有亚胺培南-西司他丁、阿莫西林-克拉维酸、哌拉西林、头孢唑肟、阿米卡星,较差有磺胺甲唑-甲氧苄啶和氟喹诺酮类,并且对病原菌中大肠埃希菌和肺炎克雷伯杆菌进行ESBLs试验,大肠埃希菌产ESBLs的阳性株占38.59%。有4.00%为真菌感染。结论对老年脑血管后遗症患者合并尿路感染应做细菌、真菌培养和药敏试验,以指导临床正确用药,防止耐药菌株产生与发展。

Objective To investigate changes of pathogenic bacteria and antimicrobial susceptibility test in sequelae of cerebrovascular disease associated with urinary tract infections in the aged. Methods A total of 395 urine samples of patients were collected and bacterial culture and antimicrobial suscepti-bility test were done by microscan bacteria identification and antimicrobial susceptibility system. Results The dominant pathogenic bacteria of urinary tract infections in patients were gram negative bacildi （65.33%）. Escherichia coli was the most common pathogen （45. 34% ）. Coagulase negative staphylococcus and enterococcus were most prevalent among the gram positive cocci. Antimicrobial susceptibility test revealed higher sensitivity to imipenem, amoxicillin, piperacillin, ceftizoxime and amikacin, but lower sensitility to sulfamethoxaxole-Trimethoprin and quinolones. Meanwhile, we performed ESBLs assay in escherichia coli and Klebsiella pneumoniae, and found that the positive ESBLs producing E. coil reached 38. 59%. Fungous infection accounted for 4%. Conclusion Routine urinary bacterial culture and susceptibility test in sequelae of cerebrovascular disease associated with urinary tract infections in the aged could direct the rational clinic medication and prevent the development of antimicrobial resistant strains.