老年患者尿路感染的病原菌分布及大肠埃希菌的耐药分析

Bacterial distribution and drug resistance of Escherichia coli in elderly patients with urinary tract infection

目的探讨清华大学医院老年患者尿路感染的病原菌分布情况和大肠埃希菌的耐药情况,为临床治疗老年患者尿路感染提供更合理的方案。方法对635份尿路感染的老年患者尿液标本进行分离培养,筛选大肠埃希菌产ESBLs菌株,并用K-B法进行药敏分析。结果培养出细菌共187株,其中大肠埃希菌占58.2%(109/187);大肠埃希菌仅对4种药物较敏感,即呋喃妥因、亚胺培南、阿米卡星和哌拉西林。在109株大肠埃希菌中,57.3%(62/109)菌株产ESBLs,ESBLs阳性株耐药率较阴性株高,由此统计数据可以看出耐药情况不容乐观。结论老年患者尿路感染的病原菌以大肠埃希菌为主,其耐药性严重且机制复杂,应定期监测病原菌的耐药趋势,以指导临床医生合理应用抗菌药物和减缓耐药菌株的出现。

Objective To investigate the distribution of the bacterial and drug resistance of Escherichia coli in elderly patients with urinary tract infection. Methods Total of 635 urine in elderly from the clinical departments of the were cultured and isolated. Then, the extended spectrum beta-lactamases （ESBLs）-producing Escherichia coli were screened and the drug resistances were tested by K-B method. Results Among the 189 isolated strains, the Escherichia coli accounted for 53.6%（109/187）. The resistance rates of the Escherichia coli to imipenem, piperacillin/tazobactam, amikacin and nitrofurantoin were relatively low. There were 57.3%（62/109） Escherichia coli with producing ESBLs, with a higher antibiotic tolerance rate than ESBLs （-） bacterium. Conclusions The drug resistance of pathogens in elderly patients with urinary tract infection is serious, and it is important to monitor the antimicrobial resistance.