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目的了解复发性尿路感染(UTI)的临床特点、易感因素、细菌谱及细菌耐药性,以期提高对该病的治疗效果,降低复发率。方法对60例复发性UTI患者的临床资料进行回顾性分析。结果复发性UTI以老年女性多见,临床症状不典型;大多数患者伴有糖尿病等基础病;细菌谱仍以革兰阴性杆菌为主,大肠埃希菌比例下降,奇异变形杆菌和表皮葡萄球菌等机会致病菌逐渐上升;大肠杆菌对环丙沙星耐药率最高,对亚胺培南全部敏感;表皮葡萄球菌对青霉素耐药性最高,对万古霉素全部敏感。结论复发性UTI可能与患者的免疫功能下降、内分泌改变、遗传因素、伴有其他基础疾病等密切相关。治疗复发性UTI的关键是要注意控制或去除易感因素,选择敏感、毒副作用小的抗生素。首次UTI疗程要足。
Objective To understand the clinical features, susceptibility factors, bacterial spectrum and bacterial resistance of recurrent urinary tract infection (UTI) in order to improve the therapeutic effect of the disease and reduce the recurrence rate. Methods The clinical data of 60 patients with recurrent UTI were retrospectively analyzed. Results The recurrence of UTI was more common in elderly women and the clinical symptoms were not typical. Most patients had underlying diseases such as diabetes. The bacterial spectrum was still dominated by Gram-negative bacilli and the proportion of Escherichia coli was decreased. Proteus mirabilis and Staphylococcus epidermidis Opportunistic pathogens gradually increased; Escherichia coli ciprofloxacin resistance rate is highest, all sensitive to imipenem; Staphylococcus epidermidis highest resistance to penicillin, vancomycin are all sensitive. Conclusions The recurrent UTI may be associated with decreased immune function, endocrine changes, genetic factors, and other underlying diseases. The key to the treatment of recurrent UTI is to pay attention to the control or removal of susceptible factors, the choice of sensitive, small side effects of antibiotics. The first UTI treatment should be sufficient.