呋喃妥因对脊髓损伤伴耐甲氧西林金黄色葡萄球菌复杂性尿路感染的临床疗效分析

Clinical effect analysis of nitrofurantoin on complicated urinary tract infections with methicillin-resistant staphylococcus aureus in spinal cord injury

目的分析呋喃妥因对脊髓损伤伴耐甲氧西林金黄色葡萄球菌(MRSA)复杂性尿路感染的临床疗效。方法选择广东省工伤康复医院2022年1月~12月收治的脊髓损伤伴有MRSA复杂性尿路感染患者33例为研究对象。采用自身对照试验,分别于呋喃妥因治疗前、治疗7 d和治疗14 d进行血清炎症指标、尿常规指标检测,并观察药物不良反应和评估疗效。结果治疗7 d或14 d后,血清炎症指标白细胞(WBC)、中性粒细胞百分比(NEUT%)、C反应蛋白(CRP)和降钙素原(PCT)均比治疗前降低,差异有统计学意义(P<0.05);尿常规指标中的亚硝酸盐(U-NIT)、白细胞脂酶(LE)和尿细菌培养数的阳性率均比治疗前降低,差异有统计学意义(P<0.001);治疗7 d和14 d的不良反应发生率比较,差异无统计学意义(P>0.05);治疗14 d的总有效率达92.3%,高于治疗7 d的总有效率(85.0%),但差异无统计学意义(P>0.05),治疗后总有效例数29例(87.9%)。结论呋喃妥因可减轻脊髓损伤伴MRSA复杂性尿路感染患者的炎症反应,有效抑制MRSA,可治疗复杂性尿路感染。

Objective To analyze the clinical effect of nitrofurantoin on complicated urinary tract infections(cUTI)with methicillin-resistant staphylococcus aureus(MRSA)in spinal cord injury(SCI).Methods Thirty-three patients with cUTI caused by SCI accompanied by MRSA admitted to Guangdong Work Injury Rehabilitation Hospital from January 2022 to December 2022 were selected as the research objects.The serum inflammatory indexes and urine routine indexes were detected before nitrofurantoin treatment,7 days after treatment,and 14 days after treatment in self-control trials.In addition,the adverse drug reactions and the curative effect were evaluated.Results After 7 or 14 days of treatment,the serum inflammatory indexes such as white blood cells(WBC),neutrophil percentage(NEUT%),C-reactive protein(CRP)and procalcitonin(PCT)were all lower than those before treatment,and the differences were statistically significant(P<0.05).The positive rates of nitrite(U-NIT),leukocyte lipase(LE)and the number of bacterial cultures in urine routine indexes were all lower than those before treatment,and the differences were statistically significant(P<0.001).There was no significant difference in the incidence of adverse reactions between 7 days and 14 days after treatment(P>0.05).The total effective rate after 14 days of treatment was 92.3%,which was higher than that after 7 days of treatment(85.0%),but the difference was not statistically significant(P>0.05),and there were total effective 29 cases(87.9%)after treatment.Conclusion Nitrofurantoin can alleviate the inflammatory reaction of patients with cUTI caused by SCI accompanied by MRSA,effectively inhibit MRSA and treat cUTI.