包头地区107例尿路感染临床分析

The clinical analysis of 107 cases with urinary tract infection in Baotou Area

目的 为提高尿路感染的诊治水平.方法 对107例尿路感染患者进行回顾性分析.结果 （1）尿路感染仍以女性多见 ,男∶女为1∶2,69,男性尿路感染大部分有易患因素. （2 ）清洁中段尿培养阳性率低 （43.9% ）.致病菌仍以G-菌为主 ,依次为大肠 ,克雷伯氏菌 ,G＋ 菌以粪肠球菌占首位. （3）常见致病菌对哌拉西林、环丙沙星、左氧氟沙星、头孢呋辛的耐药率高,对G-菌 （大肠埃希菌 ） ,以亚胺培南、头孢哌酮/舒巴坦、美洛培南的耐药率最低 （0% ） ,其次呋喃妥因,哌拉西林/他唑巴坦（2 0 .3% ） ,阿米卡星 （2 2 .1% ）.而对G＋ 菌 （肠球菌 ） ,万古霉素仍保持最低的耐药率 （1.0 % ）.结论 尿路感染致病菌主要为G-菌 ,一线经验选药可用阿米卡星,头孢他啶 .哌拉西林、环丙沙星、左氧氟沙星、头孢呋辛的耐药率高已广泛耐药 ;临床上对疑诊尿路感染者需要做细菌耐药性检测 ,根据其结果合理用药 ,同时及时发现和纠正易患因素.

Objective To raise the level of diagnosis and treatment of urinary tract infection （ UTI）. Methods 107 cases of UTIwere analysedretrospectively. Results （1）Malefemale ratio was 1： 2.69.The most male patients with UTI had the special factors.（ 2）The positive rate of clearing urinecultivation was low （ 43.9%）. The Gram-negative（ G）bacteria were still common bacteria fromUTI, and They were eschevichia coli, klebsiella pneumoniae inorder of priority.The commonGram - positive（ G ＋ ）bac -teria were enterococcus .（ 3）The drug resistance rate （ DRR ）of bacteria to Piperacillin,cinrofloxacin,evofloxacin,cefuroxime were high. . DRR of imipenem, Sulbactam meropenemare the lowest （0%）for G -bacteria. such as escherichia coli, furantoin,piperacillin-tazobactam （ DRR 3.3%）, and amikacin（ DRR 13.3%）.Tovancomycin was the most effected antimicrbial for G＋bacteria, such as enterococcus（ DRR 1. 0%） . Conclusions The main bacteria of UTI were G - bacteria.Amikacin and ceftazidine can be recommended as first-line empirical therapy . Thedrug resis-tance of piperacillin trimoxazole and cinrofloxacin is serious.It is suggested that there is urgent need for surveillances of bacterial resistance andrational use of antimicrobial agents should be emphasized during clinical therapy. It is also very important to find and rectify thespecial factors.