摘要
目的探讨原发性肾病综合征患者尿路感染的病原菌分布及耐药性,为临床合理应用抗菌药物提供理论依据。方法选取医院2010年1月-2015年3月原发性肾病综合征尿路感染患者240例,采集患者尿液样本进行尿液细菌培养,对阳性尿液进行病菌鉴定和耐药性分析。结果 240份尿液样本中有53份培养阳性,阳性率为22.08%;共培养出病原菌53株,其中革兰阴性菌43株占81.13%,革兰阳性菌7株占13.21%,真菌3株占5.66%;大肠埃希菌对氨苄西林耐药率最高,为81.82%,而对亚胺培南耐药率最低,为9.09%;变形菌属对氨苄西林耐药率最高,为60.00%,而对头孢唑林耐药率最低,均为0;阴沟杆菌对头孢他定耐药率最高,为75.00%,而对左氧氟沙星耐药率最低,为0;表皮葡萄球菌对庆大霉素的耐药率最高,为100.00%,而对舒巴坦耐药率最低,为0;链球菌属对头孢他定耐药率最高,为50.00%,对氨苄西林耐药性最低,为0;肠球菌属环丙沙星的耐药性最高,为100.00%,而对氨苄西林耐药性最低为0。结论原发性肾病综合征患者尿路感染的病原菌主要为革兰阴性菌,大肠埃希菌感染居多,病原菌对各类抗菌药物的耐药性有差异,治疗以亚胺培南为首选。
OBJECTIVE To explore distribution and drug resistance of pathogenic bacteria in patients with primary nephrotic syndrome complicated with urinary tract infections,so as to provide theoretical basis for the clinical use of antimicrobial agents.METHODS Totally 240 urines samples got from patients with primary nephrotic syndrome complicated with urinary tract infections were cultured from Jan.2010 to Mar.2015.Bacterial identification and drug resistance analysis were conducted in urins samples with positive culture result.RESULTS Totally 53 of 240urine samples were positive,and the positive rate was 22.08%,Bacteria culture results showed that gram-negative bacteria strains were 43,accounting for 81.13%,and gram-positive bacteria had 7strains,accounting for 13.21%,3strains of fungi were found,accounting for 5.66%.Escherichia coli and Klebsiella pneumoniae had the highest resistant rate to ampicillin,with 81.82%and 71.43%respectively.While they had the lowest drug resistance rate to imipenem with 9.09% and 14.29% respectively.Proteus was highly resistant to ampicillin with the rate of 60.00%,but was totally sensitive to cefazolin.Enterobacter cloacae had the highest resistance rate to ceftazidime with rate of 75.00%,and lowest to levofloxacin,namely 0%.Staphylococcus epidermidis were completely resistant to gentamicin,while totally sensitive to sulbactam.Streptococcus had the highest resistance rate（50.00%）to ceftazidime,while they were totally sensitive to ampicillin.Enterococcus was totally resistant to ciprofloxacin and sensitive to ampicillin.CONCLUSION The main pathogenic bacteria in patients with primary nephrotic syndrome complicated with urinary tract infection was gram-negative bacteria,in which Escherichia coli took the majority.Pathogenic bacteria have a different resistance to different antibiotics.imipenem is the first choice for treatment.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第14期3219-3221,共3页
Chinese Journal of Nosocomiology
基金
河南省医学科技公关计划基金资助项目(100)
关键词
原发性肾病综合征
尿路感染
病原菌
分布
耐药性
Primary nephrotic syndrome
Urinary tract infection
Pathogenic bacteria
Distribution
Drug resistance
