尿路感染患者奇异变形杆菌分布及耐药性分析

Distribution and Drug Resistance of Proteus Mirabilis in Patients with Urinary Tract Infection

目的研究尿路感染患者奇异变形杆菌分布特点和耐药性,为临床尿路感染患者的治疗提供可靠的参考依据。方法选取2018年8月-2021年8月在我院诊治的80例尿路感染患者为研究对象,进行奇异变形杆菌检测,观察尿路感染患者奇异变形杆菌检出率、分布特点、耐药性。结果80例尿路感染患者中,检出45株奇异变形杆菌,其中尿道口检出率42.22%,尿液检出率为31.11%,导尿管生物被膜中检出率为26.67%。奇异变形杆菌对氨苄西林耐药最高,其次为哌拉西林/他唑巴坦、庆大霉素、头孢噻肟和复方磺胺甲噁唑,对头孢他啶、亚胺培南、阿米卡星、美罗培南耐药率较低,均为20%以下,差异有统计学意义(P<0.05),尿液、尿道口以及导尿管生物被膜抗生素敏感性比较,差异无统计学意义(P>0.05);ESBLs阴性菌对以上药物的耐药性均低于ESBLs阳性菌株。结论尿路感染患者存在奇异变形杆菌,且主要分布于尿道口、尿液以及导尿管生物被膜中。不同抗生素耐药性不同,但是不同部位分离出的奇异变形杆菌对抗生素敏感性基本相似,ESBLs是形成奇异变形杆菌耐药的主要原因。临床对尿路感染患者应加强对ESBLs的检测,合理使用抗菌药物,在减少抗生素滥用现象的同时,提高尿路感染治疗疗效。

Objective To study the distribution characteristics and drug resistance of Proteus mirabilis in patients with urinary tract infection,and to provide reliable reference for the treatment of patients with urinary tract infection.Methods A total of 80 patients with urinary tract infection diagnosed and treated in our hospital from August 2018 to August 2021 were selected as the research objects.All patients were detected Proteus mirabilis,the detection rate,distribution characteristics and drug resistance in patients with urinary tract infection were observed.Results Among 80 patients with urinary tract infection,45 strains of Proteus mirabilis were detected,among which the detection rate of urinary tract entrance was 42.22%,the detection rate of urine was 31.11%,and the detection rate of catheter biofilm was 26.67%.The resistance of Proteus mirabilis to ampicillin was the highest,followed by piperacillin/tazobactam,gentamicin,cefotaxime and compound sulfamethoxazole,and the resistance rates to ceftazidime,imipenem,amikacin and meropenem were all lower than 20%,with statistically significant differences(<0.05).There was no significant difference in the sensitivity of urine,urinary tract orifice and catheter biofilm antibiotics(>0.05).The resistance of ESBLs-negative bacteria to the above drugs was lower than that of ESBLs-positive strains.Conclusion There are Proteus mirabilis in patients with urinary tract infection,which is mainly distributed in the urinary tract entrance,urine and catheter biofilm.Different antibiotic resistance is different,but the sensitivity of Proteus mirabilis isolated from different parts to antibiotics is basically similar,ESBLs is the main reason for the formation of Proteus mirabilis resistance.Clinical detection of ESBLs should be strengthened in patients with urinary tract infection.Rational use of antibiotics can reduce the abuse of antibiotics and improve the therapeutic effect of urinary tract infection.