尿脓毒血症与复杂性尿路感染病原学特点及耐药性对比研究
【摘要】 目的 探讨尿脓毒血症与复杂性尿路感染的病原学特点以及耐药性，为两者抗感染治疗提供可靠依据。方法 收集83例尿脓毒血症患者（尿脓毒血症组）以及629例复杂性尿路感染患者（复杂性尿路感染组），对尿液标本进行细菌培养，分离并鉴定病原菌，记录其来源及类型。对分离出的病原菌进行药敏试验，对患者的病原菌分布及其耐药性特点进行分析及比较。 结果 尿脓毒血症组83例患者的尿培养结果中，检出病原菌59例（71.1%），其中革兰阴性菌48株、革兰阳性菌3株、真菌8株。复杂性尿路感染组629例患者的尿培养结果中，检出革兰阴性菌516株（82.0%），革兰阳性菌76株（12.1%）、真菌37株（5.9%）。尿脓毒血症组中大肠埃希菌和真菌检出率均高于复杂性尿路感染组（P均0.05）。结论 尿脓毒血症和复杂性尿路感染病原菌均以革兰阴性杆菌为主，尤其是大肠埃希菌，治疗应根据尿培养及药敏试验结果，合理使用抗菌药物。建议将哌拉西林钠-他唑巴坦、头孢哌酮钠-舒巴坦作为尿脓毒血症患者的首选用药。
【关键词】 尿脓毒血症；复杂性尿路感染；病原学； 耐药性
【Abstract】 Objective To analyze the etiological characteristics and antibiotic resistance between urosepsis and complicated urological tract infection， aiming to provide reliable evidence for the treatment of these diseases. Methods Clinical data of 83 patients diagnosed with urosepsis and 629 cases of complicated urological tract infection were retrospectively collected. The urine samples were collected for bacterial culture to isolate and identify the pathogens. The source and type of the pathogens were analyzed. The isolated pathogens were subject to drug susceptibility test. The pathogen distribution and drug resistance characteristics were analyzed and statistically compared. Results In the urosepsis group （n=83）， the detection rate of pathogens in the urine samples was 71.1% （n=59） including 48 strains of gram-negative bacteria， 3 strains of gram-positive bacteria and 8 strains of fungi. In the complicated urological tract infecti...
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