老年患者泌尿道致病菌耐药性监测及临床意义

Surveillance of Pathogenic Bacteria in the Urinary System and Their Resistance to Antimicrobial Agents in Senile Patients

为了解老年患者常见泌尿道致病菌及其耐药性,采用17种抗菌药纸片、K-B琼脂扩散法对1996年1～12月武汉地区13所大中型医院60岁以上住院患者尿中所分离出的204株细菌进行耐药性监测,结果显示43株（21.07％）为革兰阳性球菌,161株（78.92％）为革阴性杆菌。革兰阴性杆菌中检出大肠杆菌107株（66.45％）,对环丙沙星、庆大霉素耐药率分别为72％、49％,对亚胺配南、头孢他啶、阿米卡星、头孢曲松敏感率均在90％以上。检出绿脓杆菌13株（8.07％）,未检出亚胺配南、阿米卡星、头孢他定耐药株,对环丙沙星耐药率在10％以下。革兰阳性球菌中17株（39.53％）为金葡菌,23.52％耐苯唑西林且呈多重耐药,对76％的抗生素耐药,对万古霉素、亚胺配南均敏感。17种抗菌药物对204株革兰阳性球菌及革兰阴性杆菌活性,最强者依次为亚胺配南、阿米卡星、头孢他啶。

To investigate the distribution of the pathogenic bacteria in the urinary system and their resistance to common antimicrobial agents in senile patients,all the pathogenic bacteria isolated from urine in senile hospitalized patients were collected during 1996,and their resistance to 17 antimicrobial agents were assayed by K-B method. 204 strains of pathogens including Gram-positive cocci (43,21. 07%) and Gram-negative bacilli (161,78. 92%) were obtained. In bacilli,a high resistant rate of Escherichia coli was determined to CIP and GEN (72% and 49% ,respectively) ,but a low resistant rate (<10%) to IPM, CAZ, AMK and CRQ. All of 13 strains of Pseudomonas aeruginosa susceptible to IPM,CAZ, and AMK had the resistant rate of P. aeruginosa was of less than 10%. In cocci,23. 52% of Staphylococcus aureus was MRSA and presented multiple resistance. However, no S. aureus was discovered to resistant to IPM and VAN. The susceptibility of 204 strains of bacteria to these a-gents was orderly IPM,AMK,CIP,CAZ.