老年人尿路感染常见病原菌耐药性剖析.docVIP

老年人尿路感染常见病原菌耐药性剖析 　　摘要: [目的] 探讨老年尿路感染患者的常见病原菌的耐药性。[方法] 回顾性分析440例住院尿路感染患者的中段尿标本实验室检验结果。[结果] ① 住院老年患者清洁中段尿的病原菌检出率为82.9%。② 检出的365株菌株中,大肠埃希菌占40.5%,奇异变形杆菌占17.8%,肺炎克雷伯菌占12.3%,铜绿假单胞菌占8.5%,肠球菌属占6.0%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的检出率为51.4%和42.2%。③ G-杆菌对氨苄西林、哌拉西林、环丙沙星耐药率高,对头孢哌酮舒巴坦耐药率低,对碳青酶类无耐药;G+球菌对克林霉素、克拉霉素、氧氟沙星耐药率高,对万古霉素无耐药。产ESBLs大肠埃希菌、肺炎克雷伯菌对第二、三代头孢菌素、氨苄西林、环丙沙星耐药率高,对头孢哌酮舒巴坦、丁胺卡那敏感,对碳青酶类无耐药。④ 添加酶抑制剂的抗生素对大肠埃希菌、肺炎克雷伯菌的药物敏感性极显著高于未添加酶抑制剂者。[结论] 老年人尿路感染病原菌耐药性高,头孢哌酮舒巴坦是治疗老年人尿路感染较为理想的药物。? 　　关键词: 老年人; 尿路感染; 病原菌; 耐药性; 超广谱β-内酰胺酶中图分类号:R 37, R 69 文献标志码: 　　 　　AAnalysis on antibiotic resistance of commom pathogenic bacteria among aged people with urinary tract infection 　　XU Wei-gang, QIN Jia-rong, PU Yu-mei, SHEN Yu, MA Jun (Shanghai Skin Diseases and STD Hospital, Shanghai 200443, China)? 　　Abstract: [Objective] To explore the antibiotic resistance of the common pathogenic bacteria among aged people with urinary tract infection(UTI).[Methods] Specimens of middle section of urine taken from 440 cases of hospitalized patients with urinary tract infection were examined retrospectively.[Results] ① The positive rate of clean catch midstream among hospitalized aged people was 82.9%. ② A total of 365 strains of bacteria were isolated and there were 40.5% E.coli, 17.8% P.mirabilis, 12.3% P.aeruginosa, 8.5% Klebsiella spp, 6.0% enterococcus respectively. ESBLs were isolated from 51.4% E.coli and 42.2% Klebsiella spp. ③ The resisitance rate of Gram negative bacilli to ampicillin, piperacillin and ciprofloxacin was higher, to cefoperazone/sulbactam was lower and had no resistance to carbapenems. Gram positive cocci had higher resistance rate 　　to clindamycin, clarithromycin and ofloxacin, but had no resistance to vancomycin. ESBLs were resistante to many antibiotics such as ampicillin, ciprofloxacin, the second and third generation cephalosporin, but had lower resistance to amikacin, cefoperazone/sulbactam and no resistance to carbapenems. ④ The drug sensitivity of E.coli and Klebsiella sp