保留尿路导管的间与菌尿的关系

Relationship between the duration urinarycalheter and bacteriuria

目的 探讨不同时间保留尿管与尿中细菌存在的关系及临床意义。方法 报告了350例保留尿管患者的790份尿标本中细菌存在情况及药敏实验情况,男性285例,女性65例。手术后置管患者300例。分别于置管前及置管后1,3,7,1O15d进行尿培养及药敏实验。结果 置管前及置管后1,3,7,10,15d尿细菌阳性率分别为5.0％,8.8％,35.8％,73.8％,82.8%和55.4%(P<0.001)。菌种以克雷白杆菌为主(39.0%),大肠埃希菌次之(30.6%)。结论 保留尿管后菌尿发生的高峰在7～10d。更长时间保留尿管菌尿反有下降趋势(P<0.001)。抗生素不能有效预防菌尿的发生,对无症状菌尿患者亦不宜使用抗生素治疗。

AIM To study relationship between the duration of urinarycatheter and bacteriuria in patients with indwelling catheter. METHODS 790 urine specimens from 350 patients with catheter were analysed and the urine was cultivated to get drug sensitivity. 285 cases were man, 50 woman, and 300 operated on. The specimens of the urine were get before and after indwelling catheter. Cultures and drug sensitivity were performed in 1 day before indwelling catheter and 1,3,7,10,15 day after indwelling catheter respectively.RESULTS At 1 day pre- indwelling catheter and 1,3,7,10,15 day post - indwlling catheter, positive rates of the bacteriuria were 5.0% , 8.8% , 35. 8% , 73.8% , 82.7% , 55.4% ( P < 0.001) respectively.The most common bacteria was klebsielleae which account for about 39% , and the second was Escherichia coli, about 30.6% . CONCLUSION Bacleriuria oecmr mostly at 7 - 10 day alter indwelling catheter and by contrast, bacteriuria decline over mat time ( P < 0.001). Prophylactic antibiotic therapy are not indicated for patients with catheter and asymptomatie bacteriuria should be not treated with antibiotics.