本文關(guān)鍵詞：重癥監(jiān)護病房患者尿路感染的危險因素與病原菌分布及耐藥性分析　出處：《中華醫(yī)院感染學雜志》2017年11期 　論文類型：期刊論文

  更多相關(guān)文章： 糞腸球菌 屎腸球菌 重癥監(jiān)護病房 尿路感染

【摘要】：目的探討重癥監(jiān)護病房患者尿路感染的危險因素、病原菌分布及耐藥性,為重癥監(jiān)護病房患者尿路感染的臨床預防治療實踐提供參考依據(jù)。方法選取2014年1月-2015年12月醫(yī)院收治的重癥監(jiān)護病房患者1 621例為研究對象,統(tǒng)計患者的尿路感染發(fā)生率,并對導致感染發(fā)生的相關(guān)因素、致病菌及藥敏性進行調(diào)查研究。結(jié)果 1 621例重癥監(jiān)護病房患者中,發(fā)生尿路感染患者289例,尿路感染率為17.83%;年齡、住院時間、GCS評分、昏迷時間、尿路侵入性操作和感染史等因素是導致患者尿路感染的影響因素;289例尿路感染患者共檢測出病原菌322株,其中革蘭陰性菌199株占61.80%、革蘭陽性菌111株占34.47%、真菌12株占3.73%,糞腸球菌和屎腸球菌分別檢出54株和34株;54例糞腸球菌對替考拉寧、利奈唑胺和替加環(huán)素的耐藥率較低;對喹奴普汀/達福普汀的耐藥率較高;34例屎腸球菌對萬古霉素、替考拉寧、利奈唑胺、替加環(huán)素等耐藥率較低;對青霉素G、環(huán)丙沙星的耐藥率較高。結(jié)論重癥監(jiān)護病房患者尿路感染情況較為嚴重,糞腸球菌和屎腸球菌是導致重癥監(jiān)護病房患者尿路感染的主要革蘭陽性菌,臨床實踐中應針對病原菌的藥敏試驗結(jié)果給予患者針對性的治療方案。
[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.
【作者單位】： 鄭州大學第二附屬醫(yī)院檢驗科;鄭州大學生命科學院;
【分類號】：R446.5;R691.3
【正文快照】： 況分類,尿路感染又被分成孤立性感染、散發(fā)性感染和復發(fā)性感染[2]。重癥監(jiān)護病房患者往往病情較為危重,同時為了挽救患者的生命,在臨床給予患者實施救治的過程中,各種侵入性操作手段和方法較多,這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顯著得到提升[3]

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