前列腺液细菌培养及药敏结果分析

Bacterial culture and drug sensitivity analysis of prostate fluid samples

目的分析慢性前列腺炎的病原菌分布及耐药情况,为临床更好的诊疗慢性前列腺炎提供依据。方法嘱慢性前列腺炎患者停用抗生素3 d以上,清洗尿道外口,留取中段尿并按摩前列腺液作常规细菌培养及药敏试验;检测慢性前列腺炎患者血PCT。结果 121份前列腺液标本中,41份细菌培养阳性,阳性率为33.88%。检出细菌43株,其中革兰阳性球菌40株,占93.02%,革兰阴性杆菌3株,占6.98%。其中的38株葡萄球菌的药敏结果显示,均对奎奴普汀-达福普汀、利奈唑胺、万古霉素及替加环素敏感,而对青霉素和红霉素耐药。38株葡萄球菌对其他种类抗生素亦有不同程度的耐药。3株革兰阴性杆菌药敏结果显示,对常见的抗生素均敏感。检查血PCT的患者30人,27人结果呈阳性(PCT>0.02 ng/ml),占90.00%。治疗前、后患者的NIH-CPSI分别为(15.4±4.3)和(4.2±3.6)(P<0.001)。结论革兰阳性球菌在慢性前列腺炎病原菌分布中占有较大比例,检测慢性前列腺炎患者血PCT可能有一定的意义;在慢性前列腺炎的诊疗过程中应注重前列腺液细菌培养及抗生素的价值,并严格掌握抗生素的使用指征,避免滥用抗生素。

Objective To analyze the pathogenic bacteria distribution and drug resistance of chronic prostatitis,offer a better way for the diagnosis and treatment of chronic prostatitis. Methods Patients with prostatitis were asked to stop the treatment of any antibiotics for more than 3 days, clean their orificium urethrae externum prior to collecting prostatic fluid. Midstream urine and prostatic fluid samples were collected for bacterial culture and drug sensitivity test, and the blood samples of 30 patient were taken for detecting procalcitonin. Results In all 121 prostatic fluid samples, 41 of them showed positive resuh in bacterial cul- ture, the positive rate was 33.88%; 43 bacterial strains, including 40 strains of Gram - positive bacteria, accounting for 93.02% , 3 strains of Gram - negative bacteria, accounting for 6.98%. Drug sensitivity results from 38 cases of staphylococcal strains showed they were all sensitive to quinupristin - dalfopristin, linezolid, vancomycin and tigecycline, but resistant to peni-cilinc, erythromycin and other antibiotics. Drug sensitivity results from 3 strains of Gram - negative bacteria showed they were sensitive to common antibiotics. In all 30 blood samples for detecting procalcitonin, 27 of them showed positive results （ PCT 〉 0. 02 ng/ml）, accounting for 90. 00%. The NIH - CPSI between pre - treatment and post - treatment were （ 15.4 _＋ 4.3 ） and （4.2 _＋ 3.6） （ P 〈 0. 001 ）. Conclusion Gram - positive cocci occupy a large proportion in the pathogenic bacteria distribution of chronic prostatitis. Detecting procaleitonin may have some significance for the diagnosis of patients with chronic bacterial pros- tatitis. Doctors should pay attention to the value of bacterial culture and antibiotics in the diagnosis and treatment of patients with chronic prostatitis, and strictly comply with the using indication of antibiotics to prevent abuse of antibiotics.