泌尿系统感染继发血流感染患者病原学及耐药性分析

Analysis of etiology and drug resistance of patients with urinary tract infection secondary to bloodstream infection

目的分析泌尿系统继发血流感染患者病原学及耐药性,为预防和控制继发血流感染提供有效临床依据。方法收集泌尿外科2015～2016年泌尿系统血流感染病例,对病原学分布和药敏结果进行回顾性分析。结果 965例泌尿系统感染患者尿培养分离出的病原菌主要为大肠埃希菌、肺炎克雷伯菌、粪肠球菌和屎肠球菌。其中43例继发血流感染患者分离出的病原菌与泌尿系统感染患者相似。大肠埃希菌和肺炎克雷伯菌对左氧氟沙星、哌拉西林/他唑巴坦、亚胺培南耐药率略有差异,粪肠球菌和屎肠球菌对利奈唑胺、万古霉素的耐药率较低。结论泌尿系统感染患者易继发血流感染,提示临床应注重泌尿系统感染患者的抗感染治疗、严格无菌操作,合理应用抗菌药物,减少血流感染的发生率。

Objective To analyze the etiology and drug resistance of patients with urinary system infection secondary to bloodstream infections,to provide an effective clinical basis for the prevention and control of secondary bloodstream infections.Methods Urinary infections and bloodstream infections were collected from urology in 2015-2016.and the pathogenic distribution and drug susceptibility resuits were retrospectiveiy analyzed.Results The pathogens isolated from urine culture of 965 patients with urinary tract infection were Escherichia coli,Klebsiella pneumoniae,Enterococcus faecalis and Enterococcus faecium.The pathogens isolated from 43 patients with secondary bloodstream infection was similar to that of patients with urinary tract infection.The resistance rates of Escherichia coli and Klebsiella pneumoniae to levofloxacin,piperacillin/tazobactam and imipenem were slightly different.the linezolid and vancomycin of Enterococcus faecalis and Enterococcus faecium were low resistance rates.Conclusion Patients with urinary tract infections are prone to secondary bloodstream infections,suggesting that clinical attention should be paid to anti-infective treatment of patients with urinary tract infections and invasive procedures under strict aseptic conditions,rational use of antibacterial drugs,and reduction of the incidence of bloodstream infections.