泌尿系统感染的病原菌分布及结果分析

Study on the pathogens and results analysis in patients with urinary tract infection

目的:调查我院近三年来泌尿系感染患者病原菌分布情况,并对耐药情况进行分析,为临床感染初级预防及经验用药提供依据。方法:对聊城市退役军人医院2017年1月~2020年3月的门诊及住院患者尿液标本2756例进行回顾性分析。结果:共检出1096株病原菌,其中革兰氏阴性杆菌680例,革兰氏阳性球菌332例,真菌84例。大肠埃希菌(36.13%)最多,其次为肺炎克雷伯菌(8.76%)、屎肠球菌(8.39%)、凝固酶阴性葡萄球菌(6.57%)、无乳链球菌(3.65%)。男性泌尿系感染,多发生于>60岁患者。<40岁女性泌尿系统感染中,大肠埃希菌检出比例最高。革兰氏阴性菌的主要敏感药物是亚胺培南、哌拉西林/他唑巴坦、阿米卡星和呋喃妥因。革兰氏阳性菌的主要敏感药物是万古霉素、替加环素、四环素和呋喃妥因。结论:大肠埃希菌仍为泌尿系感染的常见致病菌。呋喃妥因和哌拉西林/他唑巴坦对常见致病菌的敏感性高,副作用低,可用于经验性治疗。

Objective:In this article we provide the pathogen and drug resistance in patients with urinary tract infection(UTI)in recent three years.We try to suggest treatment of bacterial cystitis in the primary care setting.Methods:A retrospective analysis was conducted on 2756 urine specimens from outpatient and inpatient patients in Liaocheng Veterans Hospital from January 2017 to March 2020.Results:A total of 1096 strains of pathogenic bacteria were detected,including 680 gram-negative bacilli,332 gram-positive cocci and 84 fungi.Escherichia coli(36.13%)was the most common,followed by Klebsiella pneumoniae(8.76%),Enterococcus faecalis(8.39%),coagulase-negative Staphylococcus aureus(6.57%)and Streptococcus agalactiae(3.65%).Male urinary tract infection,the majority of>60 years old patients.The highest proportion of Escherichia coli was found in women under 40 years of age.The main sensitive drugs for Gram-negative bacteria are imipenem,piperacillin/tazobactam,amikacin and nitrofurantoin.The main sensitive drugs for Gram-positive bacteria are vancomycin,tetracycline,tetracycline and nitrofurantoin.Conclusion:Escherichia coli is still the common pathogenic bacterium of urinary tract infection.Furantoin and piperacillin/tazobactam have high sensitivity and low side effects to common pathogenic bacteria and can be used for empirical treatment.