颅脑损伤患者尿路感染病原菌分布及耐药性分析

Distribution and antibiotic resistances of pathogens in urinary tract infection patients with craniocerebral trauma

目的探讨颅脑损伤患者尿路感染病原菌分布及其耐药性,为临床合理选择抗生素提供参考。方法以颅脑损伤伴尿路感染患者为研究对象,将单纯尿路感染患者作对照,进行菌种鉴定和药敏试验,比较两组病原菌分布及其耐药性。结果 (1)脑外伤组G-杆菌以变形杆菌多见,其次为大肠埃希菌、鲍曼不动杆菌和肺炎克雷伯菌;对照组以大肠埃希菌多见,其次为肺炎克雷伯菌、变形杆菌和鲍曼不动杆菌。两组G-杆菌细菌分布比较,差异具有显著性(P<0.01);(2)脑外伤组大肠埃希菌、肺炎克雷伯菌和变形杆菌对头孢噻肟耐药率显著低于对照组,差异有统计学意义(P<0.05);两实验组病原菌对阿米卡星、头孢吡肟、亚胺培南耐药率均较低,但差异无统计学意义(P>0.05)。结论颅脑损伤伴尿路感染患者病原菌分布与单纯尿路感染患者不同,第三、四代头孢和半合成氨基糖苷类为相对敏感抗生素。

Obiective To explore the distribution and antibiotic resistances of pathogens in urinary tract infection patients with craniocerebral trauma.Method 74 patients with craniocerebral trauma suffered urinary tract infection were divided into the observation group,and 70 patients suffered urinary tract infection only were divided into the control group.The distribution of the pathogens and their antibiotic resistances were compared between the two groups.Results(1)In the observation group,Proteusbacillus was the most common among G-bacilli,followed by Escherichia coli,Bauman Acinetobacter and Klebsiella pneumoniae;in the control group,Escherichia coli was the most common,followed by Klebsiella pneumoniae,Proteus and Bauman acinetobacter.There was a significant difference in G-bacillus distribution between the two groups(P<0.01);(2)The drug resistance rates of Escherichia coli,Klebsiella pneumoniae and Proteusbacillus to cefotaxime in the observation group were significantly lower than those in the control group.The drug resistance rates of the two groups to amikacin,imipenem and cefotaxime were all at a low level,but there were no significant differences between the two groups.Conclusion There was a significant difference in pathogenic bacteria distribution between the patients with urinary tract infection and craniocerebral trauma and the patients with urinary tract infection only.The third and fourth generation cephalosporin and semi-synthetic aminoglycosides are relatively effective antibiotics.