系统性红斑狼疮与狼疮肾炎住院患者感染病原菌分析

发布时间：2018-05-17 02:21

本文选题：红斑狼疮 + 系统性　；参考：《重庆医学》2016年36期

【摘要】：目的回顾性分析系统性红斑狼疮(SLE)和狼疮肾炎(SLE-LN)住院患者感染病原菌的分离情况,为感染患者提供诊治依据。方法选取2010~2014年该院诊断为SLE与SLE-LN的住院患者380例,其中SLE-LN患者96例。用常规方法进行细菌接种、培养、分离鉴定和药敏试验。采用SPSS19.0和WHONET 5.6软件进行统计分析与药敏分析。结果 SLE和SLELN患者尿路感染者分别占25.0%和27.1%,血流感染者分别占8.1%和10.4%,皮肤组织感染者分别占12.0%和8.3%。分离的革兰阴性菌以大肠埃希菌为主,在SLE患者中占25.53%,SLE-LN患者中占30.21%,其次是鲍曼不动杆菌,分别占13.42%和14.54%。分离的革兰阳性菌以金黄色葡萄球菌为主,在SLE患者中占11.58%,SLE-LN患者中占11.46%。69.79%的SLE患者、66.67%的SLE-LN患者尿液中分离出大肠埃希菌,高于常规尿培养中大肠埃希菌的分离率(45%),差异有统计学意义(P0.01)。SLE患者分离大肠埃希菌对喹诺酮类抗菌药物的耐药率大于66%,对氨苄西林耐药率达89.69%,对哌拉西林/他唑巴坦的耐药率较低(3.09%)。SLE-LN患者产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌分离率均高于SLE患者。结论SLE患者发生感染的概率较高,临床可选用β-内酰胺类复方制剂治疗SLE患者大肠埃希菌尿路感染。
[Abstract]:Objective to retrospectively analyze the isolation of pathogenic bacteria from patients with systemic lupus erythematosus (SLE) and lupus nephritis (SLE-LN). Methods from 2010 to 2014, 380 inpatients with SLE and SLE-LN were selected, including 96 patients with SLE-LN. Bacteria inoculation, culture, isolation and identification and drug sensitivity test were carried out by routine methods. SPSS19.0 and WHONET 5.6 software were used for statistical analysis and drug sensitivity analysis. Results urinary tract infection rate was 25.0% and 27.1% in SLE and SLELN patients, blood flow infection accounted for 8.1% and 10.4%, skin tissue infection accounted for 12.0% and 8.3% respectively. Escherichia coli was the main type of Gram-negative bacteria isolated, 25.53% of the patients with SLE and 30.21% of the patients with SLE-LN, followed by Acinetobacter baumannii, 13.42% and 14.54%, respectively. Staphylococcus aureus was the main gram-positive bacteria isolated. Escherichia coli was isolated from the urine of 11.46.69.79% of SLE patients and 66.67% of SLE-LN patients. The isolation rate of Escherichia coli was higher than that of routine urine culture. The difference was statistically significant (P 0.01). The resistance rate of Escherichia coli to quinolone antibiotics was greater than 66, ampicillin resistance rate was 89.69 and piperacillin / tazole resistance rate was higher than 66. The isolation rates of Escherichia coli and Klebsiella pneumoniae from patients with extended-spectrum 尾 -lactamases were higher than those with SLE. Conclusion the probability of infection in SLE patients is high. 尾-lactam compound preparation can be used to treat SLE patients with Escherichia coli urinary tract infection.
【作者单位】：四川大学华西医院实验医学科;
【基金】：国家自然科学基金资助项目(81000712)
【分类号】：R446.5;R593.24

【相似文献】