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目的 了解脑卒中患者尿路感染病原菌的分布及主要致病菌的耐药性 ,以指导临床合理使用抗生素。方法 对 1997～ 2 0 0 3年间送检的住院脑卒中患者的导尿标本进行细菌培养、分离、鉴定和药敏试验 ,并用WHONET -5耐药分析软件对分离出的致病菌进行结果分析。结果 70 0例脑卒中患者导尿标本中有 2 0 1例分离出致病菌 ,阳性率为2 8 7% ,其中 83例为两种菌混合感染。分离出细菌 2 41株 ,酵母样真菌 43株 ,主要致病菌为大肠埃希菌 (3 5 9% )、酵母样真菌 (15 1% )、凝固酶阴性葡萄球菌 (14 1% )、肠球菌属 (9 2 % )及克雷伯菌属 (6 7% )。结论 脑卒中患者尿路感染以大肠埃希菌为主 ,存在由多重耐药菌株、混合菌和二重感染的真菌等多种因素引起尿路感染的情况 ,这给治疗用药带来了困难。因此 ,应重视脑卒中患者感染菌的监测 ,严格控制院内交叉感染 ,合理使用抗生素。
Objective To understand the distribution of pathogenic bacteria in urinary tract infection and the drug resistance of major pathogenic bacteria in stroke patients so as to guide the rational use of antibiotics in clinical practice. Methods The bacterial culture, isolation, identification and drug susceptibility tests of catheterization specimens from hospitalized patients with stroke admitted from 1997 to 2003 were carried out and the results were analyzed with WHONET -5 drug resistance analysis software . Results The pathogenic bacteria were isolated from 210 cases of catheterization in 70 0 stroke patients, the positive rate was 28.7%. Among them, 83 cases were mixed with two kinds of bacteria. Two hundred and seventy-one strains of bacteria and forty-three strains of yeast-like fungi were isolated. The main pathogens were Escherichia coli (359%), yeast-like fungi (15.1%), coagulase-negative staphylococci Coccus (92%) and Klebsiella (67%). Conclusions Urinary tract infection in patients with stroke is mainly caused by Escherichia coli, which causes urinary tract infection due to multiple factors such as multi-drug resistant strains, mixed bacteria and double infection fungi, which brings difficulties for the treatment of patients. Therefore, we should pay attention to the monitoring of patients with stroke infection, and strictly control the hospital cross-infection, rational use of antibiotics.