导管相关性尿路感染临床特点分析

Clinical Character Analysis on Catheter-related Urinary Tract Infections

目的了解笔者医院综合ICU病房导管相关性尿路感染病原菌分布及耐药特性，指导临床用药。方法对笔者医院综合ICU病房2012年1～12月607例留置尿管的患者进行回顾性研究，用无菌容器采集清晨6：00清洁中段尿送检，进行细菌培养与药敏分析。结果607例留置尿管的患者39例确诊为导管相关性尿路感染，共检出病原菌67株，其中真菌45株（67．2％），革兰阴性杆菌15株（22．3％），革兰阳性球菌7株（10．4％）。真菌中白色念珠菌为主要致病菌，其对两性霉素B和氟胞嘧啶敏感，而对氟康唑及伊曲康唑相对耐药。结论导管相关性尿路感染中真菌感染率高，临床工作者需重视尿路真菌感染，进行尿培养和药敏试验指导临床用药,提高尿路感染治愈率。

Objective To anlyze the distribution and antibiotic resistance of pathogens in catheter - related urinary tract infection （CAUTI） at our general ICU and direct clinical application of the antibiotics. Methods Totally 607 catheterized patients selected from our ICU from January 2012 to December 2012 were performed with a retrospective study. Clean and middle part urine samples were col- lected with sterile container at AM 6：00. Then, those samples were performed bacterial cuhure and drug sensitivity. Results Among 607 patients indwelling catheter, 39 patients were diagnosised CAUTI. It separated 67 strains of pathogenic bacteria, with fungi 45 cases （67.2%）, gram - negative bacteria 15 cases （22.3%） , gram - positive bacteria 7 cases （ 10.4% ）. Candida albicans was the major pathogen fungi. It was sensitivity to amphotericin B and Eph cytosine, and was resistant to fluconazole and itraconazole relatively. Conclusion The rate of fungal infection was high in CAUTI. Clinical worker should pay attention to urinary fungal infection and apply of urine culture and drug sensitive test, in order to guide the clinical medication and improve the cure rate of urinary tract infection.