老年患者泌尿外科感染的病原菌分布与耐药性分析

Distribution of pathogenic bacteria and analysis of drug resistance in the elderly patients in Department of Urology

目的探讨我院泌尿外科老年患者院内感染的病原菌分布及耐药现状,为临床合理诊疗及应用抗菌药物提供依据。方法采用回顾性分析方法,收集我院2013年1月至2015年12月期间泌尿外科老年患者医院感染的病原菌分布资料,并对其药敏结果进行分析。结果共分离出386株病原菌,以大肠埃希菌为主,共145株,占37.57%;其次为粪肠球菌和屎肠球菌,分别占11.40%和9.33%。不同的病原菌对临床常用的抗菌药物有不同程度的耐药性:大肠埃希菌对头孢唑林、氨苄西林耐药率高,分别为96.52%和90.28%;粪肠球菌对喹奴普汀/达福普汀、克林霉素的耐药率高,达100.00%;屎肠球菌对克林霉素、环丙沙星、氨苄西林的耐药率较高,分别达到100.00%、94.29%、91.43%。结论泌尿外科患者发生感染主要是由留置导尿时间较长和抗菌药物的广泛使用引起的,临床医师应规范操作,合理使用抗菌药物,避免医院感染的发生。

Objective To investigate the distribution of pathogenic bacteria causing nosocomial infections and drug resistance status in the elderly patients in Department of Urology. Methods A retrospective analysis was carried out to collect the data of the distribution of pathogenic bacteria of nosocomial infections in the Department of Urology and to analyze the results of drug sensitive test from January 2013 to December 2015. Results Totally 386 strains of pathogens were isolated,in which Escherichia coli accounted for 37. 57%（145 strains）,followed by Enterococcus faecalis（11. 40%）and Enterococcus faecium（ 9. 33%）. The drug resistance rate of Escherichia coli to cefazolin or ampicillin was 96. 52% and90. 28%,respectively,and the drug resistance rate of Enterococcus faecium to quinupristin / dalfopristin or clindamycin was100. 00%,and the drug resistance rate of Enterococcus faecium to clindamycin,ciprofloxacin or ampicillin was 100. 00%,94. 29% and 91. 43%,respectively. Conclusions Prolonged catheter indwelling time and use of antibiotics widely are the main causes of infection in the Department of Urology,and clinicians should pay attention to regulation operation and to reasonable use of antibiotics in order to prevent the nosocomial infections.