侯钧,马瑜珊,张婧,康月茜,李扬,张任飞.四川省某医院精神科患者尿路感染的病原菌分布及耐药性分析[J].四川精神卫生杂志,2019,32(5):427-430.
四川省某医院精神科患者尿路感染的病原菌分布及耐药性分析
Analysis of the distribution and drug resistance of pathogenic bacteria causing urinary tract infections of psychiatric patients in a hospital in Sichuan Province
  
DOI:10.11886/j.issn.1007-3256.2019.05.009
中文关键词:  精神科  尿路感染  病原菌  耐药性
英文关键词:Psychiatric department  Urinary tract infection  Pathogenic bacteria  Antibiotic resistance
基金项目:绵阳市第三人民医院2019年一般孵化科研项目(201908)
作者单位邮编
侯钧 绵阳市第三人民医院·四川省精神卫生中心 621000
马瑜珊 绵阳市第三人民医院·四川省精神卫生中心 621000
张婧 绵阳市第三人民医院·四川省精神卫生中心 621000
康月茜 绵阳市第三人民医院·四川省精神卫生中心 621000
李扬 绵阳市第三人民医院·四川省精神卫生中心 621000
张任飞 绵阳市第三人民医院·四川省精神卫生中心 621000
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中文摘要:
      目的 了解精神科住院患者尿路感染的病原菌分布及细菌耐药情况,为临床经验性抗感染治疗提供参考。方法 收集2016年-2018年在四川省精神卫生中心精神科住院治疗且存在尿路感染的患者171例,对尿液标本进行细菌分离培养,使用质谱(MALDI-TOF-MS)和Vitek 2 Compact全自动细菌鉴定系统进行细菌鉴定,采用微量肉汤稀释法进行体外药敏试验,使用WHONET 5.6软件对药敏试验结果进行分析。结果 在发生尿路感染的精神科住院患者中,女性106例(61.99%),男性65例(38.01%)。共分离出病原菌171株,最常见的致病菌是大肠埃希菌[96株(56.14%)],其次为肺炎克雷伯菌[16株(9.36%)]和摩根菌属[9株(5.26%)]。大肠埃希菌对氨苄西林、哌拉西林、庆大霉素、环丙沙星、左氧氟沙星、复方新诺明的敏感性均低于50%;对哌拉西林/他唑巴坦、头孢西丁、亚胺培南、磷霉素、呋喃妥因的敏感性均高于90%,检出1例对亚胺培南不敏感的大肠埃希菌,未发现对美罗培南、阿米卡星耐药的菌株。结论 精神科住院患者尿路感染以女性多见,常见病原菌包括大肠埃希菌、肺炎克雷伯菌、摩根菌属,其中大肠埃希菌的耐药性较严重。
英文摘要:
      Objective To analyze the distribution of pathogens and bacterial resistance in psychiatric patients with urinary tract infection, and to provide references for clinical anti-infection treatment.Methods A total of 171 cases of psychiatric inpatients with urinary tract infections in Sichuan Mental Health between 2016 and 2018 were enrolled. Bacterial isolation and culture were carried out on the urine specimens, and the bacteria were identified by MALDI-TOF-MS and Vitek 2 Compact automatic microbial analysis system. The broth microdilution method was used for antimicrobial susceptibility test in vitro, and the results of the test were analyzed with WHONET 5.6.Results Among the psychiatric inpatients with urinary tract infections, 106 (61.99%) were female and 65 (38.01%) were male. A total of 171 strains of pathogenic bacterium were isolated, and the most common pathogens were Escherichia coli [96 strains (56.14%)], followed with Klebsiella pneumoniae [16 strains (9.36%)] and Morganella [9 strains (5.26%)]. The sensitivity of Escherichia coli to ampicillin, piperacillin, gentamicin, ciprofloxacin, levofloxacin and compound xinnoxamine were all lower than 50%, while the sensitivity to piperacillin/tazobactam, cefoxitin, imipenem, fosfomycin and nitrofurantoin were higher than 90%. One case of Escherichia coli was detected, while was not sensitive to imipenem, moreover, no meropenem- or amikacin-resistant strains were found.Conclusion Urinary tract infections in psychiatric inpatients are more common in female, and the common pathogens include Escherichia coli, Klebsiella pneumoniae and Morganella, among which Escherichia coli has more serious drug resistance.
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