长期卧床引起尿路感染患者细菌分布和耐药性分析

Bacterial distribution and analysis of drug resistance for the patient longterm bedridden caused urinary tract infection

目的调查因行动不便长期卧床患者引起尿路感染的原因。方法收集长期卧床的患者的中段尿做细菌培养及药敏试验,如果阳性,则收集患者的粪便,分离相应的细菌并做药敏试验。把同一患者尿液和粪便中分离到的两株相同细菌做脉冲电场凝胶电泳(PFGE)进行同源性分析。结果收集的123例患者中,大肠埃希菌为90对占73.2%,粪肠球菌为9对占7.3%,屎肠球菌为6对占4.9%,奇异变形杆菌6对占4.9%,肺炎克雷伯菌4对占3.3%。90对大肠埃希菌中有同源性的为63对占70%。结论院内长期卧床的患者尿路感染的发生率较高,且以自身清洁消毒不严、从肛门-尿道感染的可能性最大。建议加强自身的清洁和消毒隔离工作。

Objective To survey the reason of urinary tract infection caused by the patients＇s action inconvenience to long-term stay in bed. Methods Collected the long-term bedridden patients＇ midstream urine for bacterial culture and drug allergy test. If positive, collect the patients＇ faeces and separate the corresponding bacteria for drug allergy test. Do PFGE （Pulsed Field Gel Electrophoresis） for homologous analysis according to the two strains of bacteria separated from the same patient＇s urine and faeces. Results In the collection of 123 cases of the patients, Escherichia coli is 90 pairs,accounted for 73.2%; Dung enterococcus is 9 pairs,accounted for 7.3%; Shit enterococcus is 6 pairs,accounted for 4.9%; Proteus mirabilis is 6 pairs,accounted for 4.9%; Klebsiella pneumoniae count for 4 pairs,accounted for 3.3%. In 90 pairs of Escherichia coli, homology for 63, accounted for 70%. Conclusion In the hospital, the long-term bedridden patients with urinary tract infection incidence is higher. And their own cleaning and disinfection is lax. From the anus and urinary tract infection is most likely. Suggest to strengthen their own cleaning and disinfection work.