泌尿外科导尿管与非导尿管相关性尿路感染病原菌分布及耐药性比较

Distribution and drug resistance of pathogenic bacteria in urinary catheter related and unrelated urinary tract infections in Department of Urology

摘要:

目的 探讨泌尿外科导尿管与非导尿管相关性尿路感染病原菌及耐药性，为临床合理使用抗菌药物提供依据。方法 选取2013 年１月-2015 年10 月该院泌尿外科收治的尿路感染患者，分为导尿管组与非导尿管组。采集合格尿标本进行细菌培养及药物敏感实验，进行统计学分析。结果 导尿管组与非导尿管组病原学分布差异有统计学意义（P <0.05）。导尿管组革兰阳性菌以葡萄球菌属细菌较多，金黄色葡匋球菌为主，而非导尿管组革兰阳性菌以肠球菌属细菌为主；导尿管组革兰阴性菌以非发酵菌较多，非导尿管组以肠杆菌科细菌为主。导尿管组检出肠杆菌科细菌耐药率较非导尿管组高；导尿管组检出鲍曼不动杆菌、金黄色葡萄球菌及肠球菌耐药率高于非导尿管组。结论 导尿管与非导尿管相关性尿路感染的病原菌分布存在差异，导尿管相关性尿路感染病原菌耐药率高于非留置导尿管患者。

Abstract:

Objective To investigate the pathogenic bacteria and drug resistance of urinary catheter associated and unassociated urinary tract infections in Department of Urology and to provide evidence for rational use of antibiotics in clinic. Methods The urinary tract infections in our hospital from January 2013 to October 2015 were randomly divided into the urinary catheter associated urinary tract infection group and the catheter unassociated urinary tract infection group. Urine samples were collected. Bacterial culture and drug sensitivity test were carried out. The data were statistically analyzed. Results The pathogenic distribution was statistically different between the catheter associated urinary tract infection group and the catheter unassociated urinary tract infection group (P < 0.05). In the catheter associated urinary tract infection group, the Gram-positive bacteria were mainly Staphylococcus bacteria, especially Staphylococcus aureus; while in the catheter unassociated urinary tract infection group, the Gram-positive bacteria were Enterococcus bacteria. In the catheter associated urinary tract infection group, the Gram-negative bacteria were mainly nonfermenters, while in the catheter unassociated urinary tract infection group the Gram-negative bacteria were mainly Enterobacteriaceae. The drug-resistance rates of Enterobacteriaceae, Acinetobacter baumannii, Staphylococcus aureus and Enterococcus in the catheter associated urinary tract infection group were higher than those in the catheter unassociated urinary tract infection group. Conclusions The distribution of pathogenic bacteria is different between catheter associated urinary tract infections and catheter unassociated urinary tract infections. The drug-resistance rates of urinary catheter associated urinary tract infections are higher than those of urinary catheter unassociated urinary tract infections.