老年尿路感染患者多重耐药菌分布特点研究

Distribution characteristics of multi-drug resistant bacteria in elderly patients with urinary tract infection

目的研究老年尿路感染患者多重耐药菌分布特点。方法146例老年尿路感染患者,从其尿液标本中分离出152株多重耐药菌,进行菌株分离、药敏试验。分析152株多重耐药菌的构成特点、主要革兰阴性杆菌、革兰阳性球菌多重耐药菌耐药特性。结果152株多重耐药菌中,主要为革兰阴性杆菌,共120株(78.9%),其中大肠埃希菌32株(21.1%),铜绿假单胞菌26株(17.1%),肺炎克雷伯菌22株(14.5%),阴沟肠杆菌18株(11.8%),鲍曼不动杆菌12株(7.9%),嗜麦芽寡氧菌10株(6.6%);其次为革兰阳性球菌32株(21.1%),其中凝固酶阴性葡萄球菌16株(10.5%),肠球菌12株(7.9%),金黄色葡萄球菌4株(2.6%)。大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌均敏感于亚胺培南,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢西丁具有最低的耐药率;嗜麦芽寡氧菌完全耐药于亚胺培南,铜绿假单胞菌对亚胺培南的耐药率为38.5%,鲍曼不动杆菌对亚胺培南的耐药率为33.3%。凝固酶阴性葡萄球菌、肠球菌均完全敏感于万古霉素,对氯霉素、利福平的耐药性相对较低,对其他药物的耐药性极强。结论老年尿路感染患者多重耐药菌主要为革兰阴性杆菌,均具有较强的耐药性,只敏感于少数抗生素。

Objective To study the distribution characteristics of multi-drug resistant bacteria in elderly patients with urinary tract infection.Methods 152 strains of multi-drug resistant bacteria were isolated from the urine specimens of 146 elderly patients with urinary tract infection for strain isolation and drug sensitivity tests.The characteristics of composition,main Gram-negative bacteria and gram-positive cocci of the 152 strains of multi-drug resistant bacteria were analyzed.Results Among the 152 stains of multi-drug resistant bacteria,mainly Gram-negative bacilli,a total of 120 strains(78.9%),including 32 strains(21.1%)of Escherichia coli,26 strains(17.1%)of Pseudomonas aeruginosa,22 strains of Klebsiella pneumonia(14.5%),18 strains(11.8%)of Enterobacter cloacae,12 strains(7.9%)of Acinetobacter baumannii,10 strains(6.6%)of Oligobacteria maltophilia;followed by 32 strains(21.1%)of Gram-positive cocci,including 16 strains(10.5%)of coagulase-negative staphylococci,12 strains of enterococci(7.9%),and 4 strains(2.6%)of Staphylococcus aureus.Escherichia coli,Enterobacter cloacae,and Klebsiella pneumoniae are all sensitive to imipenem,and have the lowest resistance rate to piperacillin/tazobactam,cefoperazone/sulbactam,and cefoxitin.Oligobacteria maltophilia was completely resistant to imipenem,the resistance rate of Pseudomonas aeruginosa to imipenem was 38.5%,and that of Acinetobacter baumannii to imipenem was 33.3%.Coagulase-negative staphylococci and enterococci were completely sensitive to vancomycin,the resistance to chloramphenicol and rifampicin was relatively low,and the resistance to other drugs was extremely strong.Conclusion The multi-drug resistant bacteria in elderly patients with urinary tract infection are mainly Gram-negative bacilli,which are highly resistant and only sensitive to a few antibiotics.