重症监护病房患者尿路感染的危险因素与病原菌分布及耐药性分析

发布时间：2018-01-05 16:24

本文关键词：重症监护病房患者尿路感染的危险因素与病原菌分布及耐药性分析　出处：《中华医院感染学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨重症监护病房患者尿路感染的危险因素、病原菌分布及耐药性,为重症监护病房患者尿路感染的临床预防治疗实践提供参考依据。方法选取2014年1月-2015年12月医院收治的重症监护病房患者1 621例为研究对象,统计患者的尿路感染发生率,并对导致感染发生的相关因素、致病菌及药敏性进行调查研究。结果 1 621例重症监护病房患者中,发生尿路感染患者289例,尿路感染率为17.83%;年龄、住院时间、GCS评分、昏迷时间、尿路侵入性操作和感染史等因素是导致患者尿路感染的影响因素;289例尿路感染患者共检测出病原菌322株,其中革兰阴性菌199株占61.80%、革兰阳性菌111株占34.47%、真菌12株占3.73%,粪肠球菌和屎肠球菌分别检出54株和34株;54例粪肠球菌对替考拉宁、利奈唑胺和替加环素的耐药率较低;对喹奴普汀/达福普汀的耐药率较高;34例屎肠球菌对万古霉素、替考拉宁、利奈唑胺、替加环素等耐药率较低;对青霉素G、环丙沙星的耐药率较高。结论重症监护病房患者尿路感染情况较为严重,粪肠球菌和屎肠球菌是导致重症监护病房患者尿路感染的主要革兰阳性菌,临床实践中应针对病原菌的药敏试验结果给予患者针对性的治疗方案。
[Abstract]:Objective to investigate the risk factors, pathogenic bacteria distribution and drug resistance of urinary tract infection in patients in intensive care unit (ICU). To provide reference for the clinical practice of prevention and treatment of urinary tract infection in patients in intensive care unit. Methods the patients in intensive care unit who were admitted to hospital from January 2014 to December 2015 were selected. 621 cases were studied. The incidence of urinary tract infection was counted, and the related factors, pathogenic bacteria and drug sensitivity were investigated. Results in 1 621 patients in intensive care unit, the incidence of urinary tract infection was analyzed. 289 cases of urinary tract infection occurred, the urinary tract infection rate was 17.83%. Age, hospitalization time, GCS score, coma time, urinary tract invasive operation and history of infection were the influencing factors of urinary tract infection. A total of 322 strains of pathogenic bacteria were detected in 289 patients with urinary tract infection, of which 199 strains were Gram-negative bacteria (61.80%), 111 strains were Gram-positive bacteria (34.47%) and 12 strains were fungi (3.73% strains). 54 strains of Enterococcus faecalis and 34 strains of Enterococcus faecium were detected. The resistant rates of teicoplanin, linazolamine and tegacycline were lower in 54 cases of Enterococcus faecalis. The drug resistance rate to quinuplatin / dafopudine was higher. The resistance rates of Enterococcus faecium to vancomycin, teicoplanin, linazolamine and tegacycline were low. The drug resistance rate of ciprofloxacin to penicillin G was higher. Conclusion urinary tract infection is more serious in patients in intensive care unit. Enterococcus faecalis and Enterococcus faecium are the main gram-positive bacteria causing urinary tract infection in intensive care unit patients.
【作者单位】：郑州大学第二附属医院检验科;郑州大学生命科学院;
【分类号】：R446.5;R691.3
【正文快照】： 况分类,尿路感染又被分成孤立性感染、散发性感染和复发性感染[2]。重症监护病房患者往往病情较为危重,同时为了挽救患者的生命,在临床给予患者实施救治的过程中,各种侵入性操作手段和方法较多,这在很大程度上增加了患者遭受感染的可能性,其中尿路感染的概率也显著得到提升[3]

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