老年患者泌尿道感染病原菌分布及耐药分析

Analysis of distribution and drug resistance of pathogens for urinary infection tract in the elderly

目的研究老年泌尿系感染病原菌分布特点,为临床用药提供依据,对临床抗菌药物使用提供指导。方法2011年1月-2013年1月对251例老年泌尿系感染尿培养及药敏试验进行统计分析,数据采用Whonet 5.6软件进行统计分析。结果 251例泌尿系感染患者共检出革兰阴性菌167株占66.53%,革兰阳性菌69株占27.49%,真菌15株占5.98%;主要感染病原菌均呈现不同程度耐药现象,革兰阴性菌对亚胺培南敏感率为100.00%,大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌对阿米卡星耐药率分别为21.15%、17.95%、10.34%;粪肠球菌、金黄色葡萄球菌对万古霉素敏感率均为100%,粪肠球菌、金黄色葡萄球菌对替考拉宁耐药率分别为2.63%、7.14%。结论根据药敏试验选择抗菌药物对有效的治疗及耐药菌株的减少均有重要的临床意义。

OBJECTIVE To analyze the distribution characteristics of pathogens for senile urinary tract infection and provide the basis and guidance for clinical medication .METHODS The urine culture and the drug sensitivity test were applied to 251 patients with senile urinary tract infection for statistical analysis to provide guidance for the clinical use of antibacterial drugs .Data were statistically analyzed by the software Whonet 5 .6 .RESULTS Among the 251 patients with urinary tract infection ,gram negative bacteria were isolated in 167 patients ,accounting for 66 .53% .Gram positive bacteria were isolated in 69 patients ,accounting for 27 .49% .The fungal infection was found in 15 patients ,accounting for 5 .98% .The main infection bacteria showed different degrees of resistance . The sensitivity to imipenem of gram negative bacteria was 100% .The resistance rates of Escherichia coli ,K leb‐siella pneumoniae ,Acinetobacter baumannii to amikacin were 21 .15% ,17 .95% ,and 10 .34% respectively .The sensitivities to vancomycin of Enterococcus f aecalis and Staphylococcus aureus were both 100% .The resistance rates of E . f aecalis ,S .aureus to teicoplanin were 2 .63% ,and 7 .14% .CONCLUSION Selecting the antibiotics according to the drug sensitivity test has a clinical significance for effective treatment and decrease of drug resistant strains .