摘要
目的了解老年女性糖尿病患者尿路感染病原菌的种类分布及耐药性,为临床医师抗感染用药提供依据。方法无菌手法留取2010年1月-2013年12月212例罹患尿路感染的老年女性糖尿病患者清洁中段尿标本,进行细菌定量培养、菌株鉴定和药敏试验,试验操作按照《全国临床检验操作规程》中的临床微生物学检验技术方法进行;药敏试验采用CLSI规定的K-B法;试验全过程在质量控制合格的前提下进行。结果尿路感染患者共培养出病原菌212株,其中检出大肠埃希菌最多,占53.3%,其次为肠球菌属及肺炎克雷伯菌,分别占18.4%及11.8%;产超广谱β-内酰胺酶(ESBLs)细菌检出率为50.0%,耐甲氧西林葡萄球菌(MRS)检出率为44.4%;大肠埃希菌和肺炎克雷伯菌对磺胺甲噁唑/甲氧苄啶耐药率最高,均>60.0%,对头孢哌酮/舒巴坦和阿米卡星的耐药率较低均<15.0%,肠球菌属及凝固酶阴性葡萄球菌对万古霉素、替考拉宁、利奈唑胺的耐药率均为0。结论老年女性糖尿病患者尿路感染病原菌的种类以肠道菌群为主,耐药性程度因细菌种类不同而异,建议临床医师务必根据尿培养和药敏结果,选择敏感且无肾损害的药物进行抗感染治疗。
OBJECTIVE To understand the species distribution and drug resistance of pathogenic bacteria causing u‐rinary tract infections in elderly female patients with diabetes mellitus so as to offer evidence for reasonable use of antibiotics for anti‐infective treatment .METHODS A total of 212 mid‐stream specimen of urine from patients dur‐ing Jan .2010 to Dec .2013 were collected to perform the bacterial cultivation ,identification and susceptibility tests by the aseptic technique .National Guide to Clinical Laboratory Procedures was referred to carry out patho‐genic cultivation and identification . The susceptibility tests were performed by K‐B methods recommended by CLSI .The quality control was performed throughout the testing .RESULTS Among 212 strains of pathogenic bac‐teria ,Escherichia coli （53 .3% ） rated the top one ,followed by Enterococcus （18 .4% ） and K lebsiella pneumonia （11 .8% ） .Detection rate of ESBLs‐producing strains was 50 .0% .Detection rate of meticillin‐resistant Staphylo‐cocci （MRS） was 44 .4% .Resistance rate of sulfamethoxazole/trimethoprim against E .coli and K .pneumoniae was the highest .None of Enterococcus and coagulase‐negative Staphylococcus was found resistant to vancomycin , teicoplanin and linezolid .CONCLUSION Intestinal floras are the main pathogens infected by urinary tract in elder female patients with diabetes .Drug‐resistance of pathogenic bacteria varied from bacterial species to species .It is recommended that the clinician should choose suitable drugs that are not harmful to kidneys for anti‐infective ther‐apy based on etiological detection .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第20期4613-4615,共3页
Chinese Journal of Nosocomiology
基金
湖北省卫生厅基金资助项目(30214078)
关键词
老年
女性患者
糖尿病
尿路感染
病原菌
耐药性
Elderly
Female patients
Diabetes
Urinary tract infection
Pathogenic bacteria
Drug resistance
