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目的探讨老年尿路感染患者的病原菌分布情况,并对其耐药性进行观察和分析,以此指导临床用药和治疗。方法选取鞍山市长大医院2014年3月至2016年3月收治的206例老年尿路感染患者为研究对象,对其进行尿路感染的病原菌分布和耐药情况进行分析。结果 206例患者共培养和检验出菌株402株,男性培养出228株(56.7%),女性培养出174株(43.3%),男性与女性菌株检出情况差异有统计学意义(P<0.05)。菌株中,革兰氏菌256株(63.7%),其中革兰阴性菌129株,革兰阳性菌株127株;变形杆菌78株(19.4%),真菌43株(10.7%),枸橼酸杆菌25株(6.2%)。经过药敏实验显示,革兰阴性菌、革兰阳性菌、变形杆菌对青霉素、红霉素、复方新诺明以及喹诺酮类药物的耐药性较高,对头孢类药物如头孢拉定、头孢曲松、头孢哌酮的耐药性相对较低,差异有统计学意义(P<0.05)。结论老年尿路感染患者的主要病原菌以革兰氏菌和变形杆菌为主,均对喹诺酮类药物产生较强的耐药性,与喹诺酮类药物对尿路感染治疗效果强,但经常出现治疗不彻底,药物滥用等问题有关。可见,在临床应用中需要对上述两种药物进行合理管理,减少不科学用药对病原菌耐药性的影响,提升老年尿路感染患者的临床治疗效果。
Objective To investigate the distribution of pathogenic bacteria in elderly patients with urinary tract infection and to observe and analyze its drug resistance in order to guide clinical medication and treatment. Methods A total of 206 elderly patients with urinary tract infection admitted from March 2014 to March 2016 in Changshang Hospital of Anshan City were selected as the study subjects, and their pathogenic bacteria distribution and drug resistance in urinary tract infection were analyzed. Results A total of 402 strains (206.7%) were cultured and tested in 206 patients (174.3%). There were significant differences between male and female strains (P0.05) . Among the strains, 256 (63.7%) were Gram-positive bacteria, of which 129 were Gram-negative bacteria, 127 were Gram-positive bacteria, 78 were Proteus (19.4%), 43 were fungi 25 strains (6.2%). After susceptibility experiments showed that Gram-negative bacteria, Gram-positive bacteria, Proteus penicillin, erythromycin, cotrimoxazole and quinolone drug resistance higher cephalosporins such as cefradine, ceftriaxone , Cefoperazone was relatively low resistance, the difference was statistically significant (P <0.05). Conclusion The main pathogenic bacteria in elderly patients with urinary tract infection are mainly Gram-positive bacteria and Proteus, both of which have strong resistance to quinolones and quinolones are effective in treating urinary tract infection, but often appear to be not treated Thorough, drug abuse and other issues. Can be seen in the clinical application of these two drugs need to be properly managed to reduce the impact of unscientific drug resistance of pathogens to improve the clinical treatment of elderly patients with urinary tract infection.