摘要
目的:探讨中晚期肿瘤患者导尿管伴随尿路感染的细菌分布以及抗菌药物的敏感性。方法:选取我院收治的中晚期肿瘤患者留置导尿期间发生尿路感染者183例,取尿液进行细菌培养和药物敏感试验。结果:183例患者共分离得到细菌菌株177株,以革兰阴性菌为主,检出104株,占58.76%,其中大肠埃希菌、克雷伯杆菌分别检出49株(27.68%)和31株(17.51%);革兰阳性菌检出较少,检出73株,占41.24%,其中金黄色葡萄球菌和表皮葡萄球菌分别检出29株(16.38%)和21株(11.86%)。以大肠埃希菌、克雷伯菌为代表的革兰阴性菌普遍对头孢哌酮/舒巴坦、亚胺培南、哌拉西林/他唑巴坦敏感,敏感性分别为100.00%、97.12%、97.12%,而对氨苄西林、哌拉西林以及头孢唑林的敏感性较低,仅为9.62%、23.08%和27.88%。以金黄色葡萄球菌和表皮葡挞球菌为代表的革兰阳性菌普遍对万古霉素、丁胺卡那敏感性较高,分别达到98.63%、91.78%,而对庆大霉素、红霉素敏感性较低,仅为6.85%、26.03%。结论:引起中晚期肿瘤留置导尿患者发生尿路感染的细菌多样,在早期可根据经验给予氨苄西林和万古霉素联合应用,并根据随后的药物敏感试验对治疗方案及时进行调整,合理应用抗菌药物。
Objective： To investigate the sensitivity of advanced cancer patients with urinary tract infections associ- ated with catheters bacterial distribution and antimicrobial agents. Methods：All 183 cases of urinary tract infection occurred in catheterization of patients with advanced cancer. Results：Of 183 patients with bacterial strains were 177 i- solated Gram- negative bacteria, detected 104, accounting for 58.76%, including Escherichia coli, Klebsiella pneu- moniae were detected in 49 （27.68%） and 31 （ 17.51% ）. Gram - positive bacteria detected in 73, accounting for 41.24%, including Staphylococcus aureus and Staphylococcus epidermidis were detected in 29 （16.38%） and 21 （ 11.86% ）. Escherichia coli, Klebsiella, represented by Gram - negative bacteria generally cefoperazone/sulbactam, imipenem, piperacillin/tazobactam, sensitivity was 100.00%, 97.12%, 97.12%, lower sensitivity to ampicillin, pip- eracillin and cefazolin, and only 9. 62% ,23.08% and 27.88%. Staphylococcus aureus and epidermidis bacteria tarts represented Gram- positive bacteria common to vancomycin, amikacin sensitivity was higher,98.63% ,91.78%, and gentamicin,erythromycin with low sensitivity only 6.85% ,26.03%. Conclusion：The cause of catheterization in pa- tients with advanced cancer of urinary tract infection bacterial diversity in the early ampicillin and vancomycin may be given based on experience and subsequent drug susceptibility testing regimen timely adjustments.
出处
《现代肿瘤医学》
CAS
2015年第12期1735-1737,共3页
Journal of Modern Oncology
基金
青岛市科技局指导计划项目(编号:KZJ-27)
关键词
肿瘤
导尿管
尿路感染
抗菌药物
tumor
catheter
urinary tract infection
antimicrobial drugs
