尿路感染雷氏普罗威登斯菌的临床特征及耐药性分析

Clinical characteristics and drug resistance of Providencia rettgeri causing urinary tract infection

目的分析尿路感染雷氏普罗威登斯菌的临床特征及耐药现状,为临床预防和合理抗感染治疗提供依据。方法对医院2015年1月—2020年12月分离的尿路感染雷氏普罗威登斯菌的临床特征和耐药性进行回顾性分析,并将其与非尿路感染雷氏普罗威登斯菌的差异进行统计学分析。结果共分离到尿路感染雷氏普罗威登斯菌36株,主要来源于有基础疾病并长期留置导尿的老年男性患者,其可引起高敏C-反应蛋白、白细胞等增高,抗感染治疗多用第三、四代头孢菌素、抗假单胞菌青霉素+酶抑制剂。这类菌株对阿米卡星、氨曲南和头孢吡肟较敏感,对庆大霉素、妥布霉素、甲氧苄啶/磺胺甲恶唑的敏感性要显著高于非尿路感染菌株(P<0.05)。结论临床应积极治疗基础疾病,合理使用抗菌药物,避免泛耐药菌株的传播;同时,治疗上需区分其感染类型而选用不同种类的抗菌药物,以提高治疗效果。

Objective To analyze the clinical characteristics and drug resistance status of urinary tract infection-causing Providencia rettgeri,and to provide basis for clinical prevention and reasonable anti-infection treatment.Methods The clinical characteristics and drug resistance of urinary tract infection-causing Providencia rettgeri isolated from the hospital from January2015 to December 2020 was analyzed retrospectively,and the differences between it and the non-urinary tract infection-causing Providencia rettgeri were statistically analyzed.Results A total of 36 strains of urinary tract infection-causing Providencia rettgeri were isolated,mainly from elderly male patients with underlying diseases and long-term indwelling catheterization.These strains can increase high-sensitivity C-reactive protein,white blood cells,and other indicators.Anti-infective treatment was mainly based on third or fourth generation cephalosporins and anti-pseudomonas penicillin plus enzyme inhibitors.The urinary tract infections-causing Providencia rettgeri were more sensitive to amikacin,aztreonam,and cefepime.The sensitivity of these strains to gentamicin,tobramycin,trimethoprim/sulfamethoxazole was significantly higher than that of non-urinary tract infections-causing Providencia rettgeri(P<0.05).Conclusion The underlying diseases should be actively treated and antibacterial drugs should be used rationally to avoid the spread of pan-resistant strains.At the same time,the treatment of infections by Providencia rettgeri needs to distinguish the type of infection,and then choose different kinds of antibacterial drugs to improve the treatment effect.