清洁中段尿标本细菌培养及药敏试验结果分析对我院泌尿外科上尿路结石术后尿路感染患者抗菌药物合理使用的影响

Influence of bacterial culture and drug sensitivity test results of clean midstream urine samples on rational use of antibiotics in patients with urinary tract infection after upper urinary calculi surgery in our hospital

目的研究清洁中段尿标本细菌培养及药敏试验结果分析对上尿路结石(UUC)术后尿路感染患者抗菌药物合理使用的影响。方法选取2017年3月-2020年3月我院泌尿外科UUC术后尿路感染患者91例,均行清洁中段尿标本细菌培养及药敏试验。结果91例UUC术后尿路感染患者共培养出病原菌123株,其中革兰阴性菌74株,革兰阳性菌43株,真菌6株;其中肺炎克雷伯菌对头孢噻肟、头孢吡肟、头孢呋辛耐药性分别为80.00%、80.00%、70.00%;铜绿假单胞菌对头孢呋辛、头孢噻肟、氨曲南耐药性分别为100.00%、100.00%、76.47%;大肠埃希菌对头孢噻肟、头孢唑啉、氨苄西林耐药性分别为97.06%、88.24%、85.29%;粪肠球菌对庆大霉素、青霉素G、红霉素耐药性分别为95.24%、76.19%、71.43%;屎肠球菌对青霉素G、环丙沙星、左氧氟沙星耐药性分别为100.00%、100.00%、77.78%。结论UUC术后尿路感染患者清洁中段尿标本中病原菌种类繁多,且对多种抗生素耐药性有所差异,可指导临床抗感染药物的合理使用。

Objective To study the effect of bacterial culture and drug sensitivity test on rational use of antibiotics in patients with urinary tract infection after upper urinary calculi(UUC)operation.Methods From March 2017 to March 2020,91 patients with urinary tract infection after UUC in our hospital were selected,and bacterial culture and drug sensitivity test of clean midstream urine samples were performed.Result A total of 123 strains of pathogens were isolated from 91 patients with urinary tract infection after UUC,including 74 strains of Gram-negative bacteria,43 strains of Gram-positive bacteria and 6 strains of fungi.The drug resistance of Klebsiella pneumoniae to cefotaxime,cefepime and cefuroxime were 80.00%,80.00%and 70.00%,respectively;the drug resistance of Pseudomonas aeruginosa to cefuroxime,cefotaxime and aztreonam were 100.00%,100.00%and 76.47%,respectively;The resistance of Escherichia coli to cefotaxime,cefazolin and ampicillin were 97.06%,88.24%and 85.29%respectively;the resistance of Enterococcus faecalis to gentamicin,penicillin G and erythromycin were 95.24%,76.19%and 71.43%respectively;the resistance of Enterococcus faecium to penicillin G,ciprofloxacin and levofloxacin were 100.00%,100.00%and 77.78%respectively.Conclusion There are many kinds of pathogens in clean midstream urine samples of patients with urinary tract infection after UUC,and their resistance to a variety of antibiotics is different,which can guide the rational use of clinical anti infective drugs.