老年泌尿道感染患者的病原菌分布及耐药状况分析

Analysis on Distribution and Drug Resistance of Pathogenic Bacteria in Elderly Patients with Urinary Tract Infection

目的:探讨老年泌尿道感染患者病原菌分布及耐药状况。方法:选取2018年1月-2020年12月天水市第四人民医院收治的100例老年泌尿道感染患者为研究对象,采集所有患者尿液标本开展细菌培养,详细记录患者病原菌分布特点并展进行敏试验。结果:100例老年泌尿道感染患者,共成功分离病原菌38株,其中革兰阴性菌25株,革兰阳性菌9株;真菌4株,革兰阴性菌占比明显高于革兰阳性菌及真菌,差异有统计学意义(P<0.05)。分析革兰阴性菌、革兰阳性菌、真菌情况,发现革兰阴性菌以大肠埃希菌最多,克雷伯属次之;革兰阳性菌以肠球菌属最多,金黄色葡萄球菌次之;真菌主要表现为白色假丝酵母菌。药敏试验结果显示,革兰阴性菌对亚胺培南耐药率较低,对氨基糖苷类、头孢菌类及喹诺酮类抗生素耐药率较高;革兰阳性菌对替考拉宁、万古霉素未见耐药情况,对喹诺酮类、青霉素类、氨基糖苷类抗生素耐药率较高。结论:老年泌尿道感染以革兰阴性菌为主要病原菌,临床应加强病原菌培养能力,明确判定病原菌类型并结合耐药情况,给予合理、安全的用药指导。

Objective:To investigate the distribution and drug resistance of pathogenic bacteria in elderly patients with urinary tract infection.Methods:A total of 100 elderly patients with urinary tract infection in Tianshui Fourth People’s Hospital from January 2018 to December 2020 were selected as the study subjects.Urine samples of all patients were collected for bacterial culture,and the distribution characteristics of pathogenic bacteria in each patient were recorded in detail and drug sensitivity test was carried out.Results:A total of 38 strains of pathogenic bacteria were successfully isolated from 100elderly patients with urinary tract infection;there were 25 strains of gram negative bacteria;9 strains of gram positive bacteria;and 4 strains of fungi,the proportion of gram negative bacteria was significantly higher than that of gram positive bacteria and fungi,with statistically significant difference(P<0.05).Gram negative bacteria,gram positive bacteria and fungi were analyzed respectively.The most gram negative bacteria were Escherichia coli,followed by Klebsiella;the most gram positive bacteria were Enterococcus,followed by Staphylococcus aureus;the fungi were mainly Candida albicans.The drug resistance rate of gram negative bacteria to imipenem was low,while the drug resistance rate to aminoglycosides,cephalosporins and quinolones was high;The gram positive bacteria had no drug resistance to teicoplanin and vancomycin,but had high drug resistance to quinolones,penicillins and aminoglycosides.Conclusion:Gram negative bacteria are the main pathogenic bacteria of urinary tract infection in the elderly.In clinical practice,it is necessary to strengthen the ability to cultivate pathogenic bacteria,clearly determine the type of pathogenic bacteria and combine with drug resistance,and give clinically reasonable and safe drug guidance.