摘要
目的探讨脑卒中患者尿管相关性尿路感染(CAUTI)病原菌的种类及耐药性,为合理选择抗菌药物,防控医院感染提供依据。方法收集神经内科重症监护病房留置尿管的脑卒中患者尿液标本,进行常规细菌培养,应用全自动细菌鉴定系统进行病原菌株的鉴定,并进行药敏分析。结果送检的704例患者尿液,分离出126例病原菌株,革兰阴性菌64株,占50.8%,革兰阳性菌49株,占38.88%,真菌13株,占10.32%。前5位病原菌依次是大肠埃希菌(20.64%),粪链球菌(15.08%),肺炎克雷伯菌(12.7%),白色念珠菌(10.32%),金黄色葡萄球菌和屎球菌(9.52%)。革兰阴性菌对美罗培南和亚胺培南全部敏感,革兰阳性菌对万古霉素全部敏感,病原菌对其他抗生素均有不同程度的耐药性。结论 CAUTI首要病原菌是大肠埃希菌,其次是粪链球菌,病原菌对抗生素有不同程度的耐药性。细菌培养和药敏分析可为临床指导用药提供依据,对降低医院泌尿系统感染率是非常重要的。
Objective To investigate the distribution and the drug resistance in catheter associated urinary tract infection( CAUTI) of stroke patients,and offer scientific evidence for reasonably clinical usage of antibiotics and reduce its incidence.Methods Urine samples from strock patients in Neurology ICU were collected and cultured. Isolated bacteria and their antibiotics resistance profiles were identified and analyzed with automatic microbial analysis system. Results 126 bacterial strains were isolated from 704 urine sample. Gram negative bacteria were 64 strains,accounted for 50. 8%,Gram positive bacteria were 49 strains,accounted for 38. 88%, fungus were 13 strains, accounted for 10. 32%. Top 5 pathogens were Escherichia coli( 20. 64%),Enterococcus faecalis( 15. 08%),Klebsiella pneumoniae( 12. 7%),Candida albicans( 10. 32%),Staphylococcus aureus and Feces Enterococcus( 9. 52%). Imipenem and Meropenem in Gram negative bacteria and vancomycin in Gram positive bacteria were all sensitivity. Pathogens showed higher drug resistance to other antibiotics. Conclusion Escherichia coli is the most common bacteria in CAUTI,followed by Enterococcus faecalis. Bacteria culture and drug sensitivity tests can offer the basis for clinical rational use of antibiotics,which is important to decrease the rate of hospital acquired urinary system infection.
出处
《河南医学研究》
CAS
2017年第16期2903-2905,共3页
Henan Medical Research
关键词
脑卒中
尿管相关性尿路感染
病原菌
耐药率
stroke patients
catheter associated urinary tract infection
pathogenic bacteria
drug resistance
