脊髓损伤患者泌尿系感染常见危险因素及病原菌分布

doi:10.3969/j.issn.1006-9771.2017.04.012

摘要/Abstract

摘要： 目的　分析导致脊髓损伤患者泌尿系感染常见危险因素和病原菌分布。方法　回顾性分析本院2015年12月至2016年6月收治的452例脊髓损伤患者感染率及感染危险因素。结果　 104例(23%)确诊为泌尿系感染。分离出病原菌119株，其中革兰氏阴性菌96株(80.7%)，革兰氏阳性菌23株(19.3%)。主要危险因素有女性、侵入性操作、下肢肌力低下、神经源性膀胱和预防使用抗菌药物等。侵入性操作主要包括留置导尿、间歇导尿和其他经尿道操作，留置导尿的泌尿系感染发生率为100.0%。结论　脊髓损伤患者泌尿系感染中常见病原菌以革兰氏阴性菌为主，医务人员要结合病原菌高耐药率、高分离率的特征，合理运用抗菌药物控制病原菌的传播及其耐药性。应针对性地严密监控存在基础疾病、接受侵入性操作及肌力低下的患者。

关键词: 脊髓损伤, 泌尿系感染, 危险因素, 病原菌

Abstract: Objective To analyze the risk factors and distribution of pathogenic bacteria of urinary tract infection (UTI) patients with spinal cord injury (SCI). Methods A total of 452 patients with SCI collected from December, 2015 to June, 2016 were retrospectively analyzed. Results 104 cases (23.1%) were diagnosed as UTI. 119 strains were identified, including 96 strains of Gram-negative bacteria (80.7%) and 22 strains of Gram-positive bacteria (19.3%). Female, invasive operation, depressed lower limb muscle strength, neurogenic bladder and prevention of antibacterial agents use were considered to be the main risk infection factors. The invasive operation included indwelling urethral catheterization, intermittent catheterization and other transurethral operation. The incidence rate of UTI in patients with SCI who also accepted indwelling catheter was 100.0%. Conclusion Gram-negative bacteria is the dominated pathogenic bacteria in SCI patients with UTI. It should be noticed the characteristics of pathogen, which both may have the high drug resistance rate and high separation rate, to select exactly antimicrobial agents to control the spread and drug resistance of pathogenic bacteria. In addition, patients with underlying diseases, invasive operation and lower strength should be monitored targeted.

Key words: spinal cord injury, urinary tract infection, risk factor, pathogen

中图分类号:

R651.2

高钧，李雯，李晶. 脊髓损伤患者泌尿系感染常见危险因素及病原菌分布[J]. 《中国康复理论与实践》, 2017, 23(4): 420-423.

GAO Jun, LI Wen, LI Jing. Risk Factors and Pathogens Distribution of Urinary Tract Infection in Patients with Spinal Cord Injury　[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(4): 420-423.

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