《中国康复理论与实践》

《中国康复理论与实践》

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脊髓损伤后泌尿系感染的菌群分布及耐药特征①

赵国伟，高钧   

  1. 中国康复研究中心北京博爱医院药剂科，北京市100068。
  • 出版日期:2016-05-25 发布日期:2016-07-04

Flora Characteristics of Urinary Tract Infections after Spinal Cord Injury and Antibiotic Resistance

ZHAO Guo-wei, GAO Jun   

  1. Department of Pharmacology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Published:2016-05-25 Online:2016-07-04

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摘要： 目的调查脊髓损伤后泌尿系感染的病原菌分布、耐药性及抗生素使用情况。方法2014 年6 月~2015 年6 月并发尿路感染的脊髓损伤住院患者145 例，对菌株构成、菌株耐药特点及抗生素使用情况进行回顾。结果脊髓损伤患者泌尿系感染常见的致病菌以大肠埃希菌(48.9%)、肺炎克雷伯菌(19.7%)、奇异变形杆菌(9.0%)等革兰氏阴性菌为主；革兰氏阳性菌感染较少，主要以金黄色葡萄球菌为主。主要革兰阴性致病菌对第二、三代头孢类抗生素和喹诺酮类中高度耐药，对含β-内酰胺酶抑制剂的复方制剂和氨基苷类耐药率较低。抗生素使用合理性有待进一步提高。结论脊髓损伤后泌尿系感染病原菌以革兰氏阴性菌为主，有较强耐药性。应根据细菌培养和药敏实验结果，合理选择抗生素，并不断优化治疗方案。

关键词: 脊髓损伤, 泌尿系感染, 病原菌, 抗生素, 耐药性

Abstract: Objective To investigate the flora of pathogens and antibiotic resistance of urinary tract infection after spinal cord injury. Methods From June, 2014 to June, 2015, 145 inpatients with urinary tract infection after spinal cord injury were reviewed. Results The main pathogenic germs were found as E. coli (48.9%), K. pneumonia (19.7%) and P. mirabilis (9.0%), and they were resistant to the second or third generation cephalosporins and quinolones moderately or severely, but sensitive to β-lactamase inhibitor combinations and aminoglycosides. The strategy of antibiotics need more reasonable. Conclusion The main pathogens in urinary tract infection after spinal cord injury are Gram-negative bacilli, that are resistant to antibiotics. The antibiotics should be selected and used rationally according to bacterial culture.

Key words: spinal cord injury, urinary tract infection, pathogens, antibiotics, resistance