对高龄患者发生大肠埃希菌所致尿路感染的特点及该细菌耐药性的分析

Analysis on clinical distribution and drug resistance of Escherichia coli fromurine tract infections in elderly patients

目的 :探讨高龄患者发生大肠埃希菌所致尿路感染的特点,分析致病菌的耐药性,为此类患者的临床治疗提供可靠的参考依据。方法 :对2013年1月1日~2015年1月1日期间我院收治的1028例大肠埃希菌所致尿路感染患者的临床资料进行回顾性研究。这些患者入院后,我们对其均进行了尿液培养,导致其发生尿路感染的致病菌均为大肠埃希菌。在这1028例患者中,大于80岁的患者有188例。探讨这188例高龄患者发生大肠埃希菌所致尿路感染的特点,并分析大肠埃希菌的耐药性。结果 :在这1028例大肠埃希菌所致尿路感染患者中,存在产ESBLs病原菌的患者有389例。在这188例高龄患者中,存在产ESBLs病原菌的患者有116例,差异具有显著性(P<0.05)。这188例高龄患者主要分布在泌尿外科、肾内科、神经内科及神经外科。这188例高龄患者体内的大肠埃希菌对大多数抗生素均具有耐药性,其对亚胺培南、美洛培南的耐药性较低,其对环丙沙星、哌拉西林、左旋氧氟沙星的耐药性较高。这188例高龄患者体内产ESBLS的病原菌对哌拉西林、左旋氧氟沙星、环丙沙星、头孢曲松、头孢呋辛、复方新诺明、氨曲南的耐药性较高。此类患者...

To investigate elderly patients with urinary tract infections caused by Escherichia coli resistance characteristics, provide the basis for clinical diagnosis and the rational use of antibiotics. Methods: Since January 1, 2013 to January 1, 2015 elderly patients with urinary tract infection, urine culture of Escherichia coli were isolated from 188 cases of clinical distribution and antibiotic resistance were analyzed retrospectively. Results: Escherichia coli mainly in Urology, Nephrology, Neurology, which produce ESBLs (extended spectrumB lanctamases, ESBLs) total 116 cases of E. coli, the detection rate of up to 61.7%, the majority of antibiotic resistance, and almost more for multi-drug resistant, low rate of resistance to imipenem and meropenem resistance rate, followed by cefoperazone sulbactam, piperacillin-tazobactam, amikacin, piperacillin and ofloxacin resistance rate. Conclusions: Elderly patients with multi-drug resistant high proportion of urinary tract infection, treatment is difficult, the clinician should be combined with urine culture and sensitivity test results, rational use of antibiotics to reduce the detection rate of ESBLs.