| 摘要: |
| 目的了解中老年女性复杂性尿路感染的复杂病因及病原学特点，为提高临床诊断准确性、合理选择抗生素提供依据。方法选择344例中老年女性复杂性尿路感染患者为研究对象，其中332例中段尿培养阳性；对其复杂病因、菌群分布、耐药性及治疗效果进行分析。结果344例中老年女性复杂性尿路感染患者的复杂病因以糖尿病（49.1%）、尿路结石（25.0%）为主；其中合并2种及以上复杂病因的占25.3%。332份尿培养阳性标本中，病原菌以大肠埃希菌（48.8%）、肺炎克雷伯杆菌（11.1%）和屎肠球菌（10.8%）为主。对162株大肠埃希菌进行药敏试验，发现它们对氨苄西林（89.5%）、喹诺酮类（74.7%）及头孢菌素类（73.4%）等抗生素的耐药性较高。根据药敏试验结果予合适的抗生素治疗，总有效率为90.0%。结论中老年女性复杂性尿路感染的病原菌以大肠埃希菌为主，且耐药菌株不断增加。建议及时检测并根据病原菌种类及其耐药情况合理用药，以提高治疗效果。 |
| 关键词: 复杂性尿路感染 中老年 女性 致病菌 |
| DOI：10.12056/j.issn.1006-2785.2017.39.10.2017-345 |
| 分类号: |
| 基金项目:杭州市卫生计生科技计划一般项目（2015A20）；杭州市医学重点专科专病项目（20150733Q30） |
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| Pathogenic characteristics of complicated urinary tract infections in middle and old aged women |
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PAN Huixian, ZHU Jingyu, LI Junhua, WANG Yanbin, LI ruipeng, LOU Yangfeng
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Hangzhou Third People's Hospital
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| Abstract: |
| Objective To investigate the pathogenic characteristics of complicated urinary tract infections in elderly women. Methods Three hundred and forty four female patients aged 50-89 (71.3±10.7) years with complicated urinary tract infection were enrolled in the study; the middle urine culture was positive in all patients. The comorbidities, flora distribution, drug resistance and treatment effects of patients were analyzed. Results The most common comorbidity in this group of patients was diabetes mellitus (49.1%), followed by urinary calculi (25.0%), and 25.3% of patients had two or more than two comorbidities. In 332 urine culture positive specimens, Escherichia coli(48.8%), Klebsiella pneumoniae (11.1%) and Enterococcus faecium(10.8%) were the main pathogens. The antimicrobial susceptibility test of 162 strains of Escherichia coli showed that it was resistant to ampicillin (89.5% ), quinolones (74.7% ) and cephalosporins (73.4% ). The overall efficacy rate of antibiotic therapy selected according to susceptibility test was 90.0%. Conclusion To improve the therapeutic effect for middle and old aged women with complicated urinary infection, it is necessary to timely perform susceptibility test and to rationally administrate antibiotics based on the testing results. |
| Key words: Complicated urinary tract infectio Elderly Women Pathogenic bacteria |
