老年患者尿培养阳性病原菌的耐药性分析

摘要

Objective:This paper is to investigate the distribution and resistance to pathological bacteria in culture-positive urine for senile patients, and provide the evidence about the clinical application of antibiotics for urine-tract infection patients. Methods:Informed by the retrospective statistical method, the pathological bacteria, which are in the culture-positive urine of senile patients (age>60) from March 2010 to March 2011, are collected and statistically analyzed. Results:①It has isolated total 252 bacterial strains, which are:146 Gram-negative (G-) strains, 56 Gram-positive (G+) strains, 50 candida strains, and the percentages are 57.94%, 22.23%and 19.83%. And the largest isolated bacterial strains are:109 escherichia coli strains, 44 Staphylococcus epidermidis strains, 42 Grape Candida strains, and the percentages are 43.25%, 17.46%and 16.67%. Considering the kinds of diseases, it shows that most samples are the simple urinary tract infection (acute nephritis) with 51.98%(131/252), and the second most samples are basic diseases (diabetes mellitus) with 18.25%(46/252).②The bacterial resistance of G-bacteria and G+bacteria is:more than 50%for penicillin and quinolones drugs, and sensitive for imipenem and chloromycetin drugs. The bacterial resistance of candida bacteria is:more than 83.14%for terbinafine drugs, and sensitive for ketoconazole. Conclusion: G-bacteria are the main pathogen of urine-tract infection for senile patients in this hospital. Besides, it shows that candida bacteria are in high percentage, and the bacterial resistance of G+bacteria is serious for a variety of drugs.%　　目的：了解本院老年患者尿液培养阳性标本的病原菌分布与药敏状况,为临床合理选用药物治疗尿路感染提供依据。方法：采用回顾性统计方法,对2010年3月～2011年3月本院60岁以上老年患者尿培养阳性标本的病原菌进行分析统计。结果：①共分离菌株252例(株)。其中：草兰氏阴性(G-)杆菌146株,革兰阳性(G+)球菌56株,假丝样酵母菌50株,分别占阳性菌株总数的57.94%、22.23%和19.83%。分离量最多的菌种为：大肠埃希菌109株、表皮葡萄球菌44株和葡萄假丝酵母菌42株,构成比分别为：43.25%、17.46%及16.67%。按疾病种类分布,单纯的尿路染(急性肾炎)的构成比最高达51.98%(131/252),基础性疾病(糖尿病)中的构成比18.25%(46/252)占次位；②G-杆菌、G+球菌对青霉素、及奎喏酮类耐药率达50.0%以上,对亚胺培南及氯霉素表现较为敏感。假丝样酵母菌对特比萘芬表现出高耐药性达83.14%,对酮康唑表现为敏感。结论：G-杆菌是本院老年患者尿路感染的主要病原菌,假丝样酵母菌所占比例较高,G+球菌对多种药物耐药现象严重。