中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2015年
5期
380-383
,共4页
重症医学科%尿路感染%细菌
重癥醫學科%尿路感染%細菌
중증의학과%뇨로감염%세균
Intensive care unit%Urinary tract infection%Bacteria
目的 分析重症医学科(intensive care unit,ICU)患者尿路感染的细菌构成及入住ICU不同时间段尿路感染细菌的变化情况.方法 回顾性分析2012年1月至2013年3月ICU收治的1 330例留置尿管患者的临床资料,男705例,女625例.年龄11～ 94岁,平均(55.4±19.2)岁.急性生理及慢性健康Ⅱ评分1～69分,平均(17.1±9.3)分.留置尿管时间1～28 d,平均23 d.使用无菌注射器收集留置尿管中的尿液行细菌培养,记录尿路感染的发生率、感染的细菌谱及其构成比,以及患者入住ICU第1、2、4周发生尿路感染的细菌构成情况.结果 本组1 330例中发生尿路感染36例(2.7％),其中男性感染率为3.0％(21/705),女性为2.4％(15/625).共分离病原菌株49株,其中革兰阴性杆菌32株(65.3％),革兰阳性球菌16株(32.7％),真菌1株(2.0％).占主导地位的细菌分别为屎肠球菌15株(30.6％)、大肠埃希菌11株(22.4％)、鲍曼不动杆菌5株(10.2％)、肺炎克雷伯菌(10.2％).患者入住ICU第1、2、4周的尿路感染中,革兰阴性杆菌分别为8株(50.0％)、4株(57.1％)、20株(76.9％),革兰阳性球菌分别为7株(43.8％)、3株(42.9％)、6株(23.1％);真菌尿路感染仅出现在入住ICU第1周,为1株(6.3％).结论 ICU尿路感染的病原菌以革兰阴性杆菌为主,真菌尿路感染发生较少.革兰阴性杆菌以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌为主,革兰阳性球菌以屎肠球菌为主.患者入住ICU前2周革兰阴性杆菌与革兰阳性球菌构成比相近,2周以后革兰阴性杆菌构成比增加.
目的 分析重癥醫學科(intensive care unit,ICU)患者尿路感染的細菌構成及入住ICU不同時間段尿路感染細菌的變化情況.方法 迴顧性分析2012年1月至2013年3月ICU收治的1 330例留置尿管患者的臨床資料,男705例,女625例.年齡11～ 94歲,平均(55.4±19.2)歲.急性生理及慢性健康Ⅱ評分1～69分,平均(17.1±9.3)分.留置尿管時間1～28 d,平均23 d.使用無菌註射器收集留置尿管中的尿液行細菌培養,記錄尿路感染的髮生率、感染的細菌譜及其構成比,以及患者入住ICU第1、2、4週髮生尿路感染的細菌構成情況.結果 本組1 330例中髮生尿路感染36例(2.7％),其中男性感染率為3.0％(21/705),女性為2.4％(15/625).共分離病原菌株49株,其中革蘭陰性桿菌32株(65.3％),革蘭暘性毬菌16株(32.7％),真菌1株(2.0％).佔主導地位的細菌分彆為屎腸毬菌15株(30.6％)、大腸埃希菌11株(22.4％)、鮑曼不動桿菌5株(10.2％)、肺炎剋雷伯菌(10.2％).患者入住ICU第1、2、4週的尿路感染中,革蘭陰性桿菌分彆為8株(50.0％)、4株(57.1％)、20株(76.9％),革蘭暘性毬菌分彆為7株(43.8％)、3株(42.9％)、6株(23.1％);真菌尿路感染僅齣現在入住ICU第1週,為1株(6.3％).結論 ICU尿路感染的病原菌以革蘭陰性桿菌為主,真菌尿路感染髮生較少.革蘭陰性桿菌以大腸埃希菌、肺炎剋雷伯菌、鮑曼不動桿菌為主,革蘭暘性毬菌以屎腸毬菌為主.患者入住ICU前2週革蘭陰性桿菌與革蘭暘性毬菌構成比相近,2週以後革蘭陰性桿菌構成比增加.
목적 분석중증의학과(intensive care unit,ICU)환자뇨로감염적세균구성급입주ICU불동시간단뇨로감염세균적변화정황.방법 회고성분석2012년1월지2013년3월ICU수치적1 330례류치뇨관환자적림상자료,남705례,녀625례.년령11～ 94세,평균(55.4±19.2)세.급성생리급만성건강Ⅱ평분1～69분,평균(17.1±9.3)분.류치뇨관시간1～28 d,평균23 d.사용무균주사기수집류치뇨관중적뇨액행세균배양,기록뇨로감염적발생솔、감염적세균보급기구성비,이급환자입주ICU제1、2、4주발생뇨로감염적세균구성정황.결과 본조1 330례중발생뇨로감염36례(2.7％),기중남성감염솔위3.0％(21/705),녀성위2.4％(15/625).공분리병원균주49주,기중혁란음성간균32주(65.3％),혁란양성구균16주(32.7％),진균1주(2.0％).점주도지위적세균분별위시장구균15주(30.6％)、대장애희균11주(22.4％)、포만불동간균5주(10.2％)、폐염극뢰백균(10.2％).환자입주ICU제1、2、4주적뇨로감염중,혁란음성간균분별위8주(50.0％)、4주(57.1％)、20주(76.9％),혁란양성구균분별위7주(43.8％)、3주(42.9％)、6주(23.1％);진균뇨로감염부출현재입주ICU제1주,위1주(6.3％).결론 ICU뇨로감염적병원균이혁란음성간균위주,진균뇨로감염발생교소.혁란음성간균이대장애희균、폐염극뢰백균、포만불동간균위주,혁란양성구균이시장구균위주.환자입주ICU전2주혁란음성간균여혁란양성구균구성비상근,2주이후혁란음성간균구성비증가.
Objective To investigate bacterial spectrum characteristics and distribution of urinary tract infections with different time phase in intensive care unit(ICU).Methods From January 2012 to March 2013,the clinical data of 1330 cases in ICU,treated with urinary catheter indwelling,was retrospectively reviewed.Among them,705 cases were male and 625 cases were female.Their age ranged from 11 to 94 years old,mean (55.4 ± 19.2)years old.Acute physiology and chronic health scores (APACHE Ⅱ) were 1 to 69,mean 17.1 ±9.3.Duration of catheter indwelling ranged from 1 to 28 days,mean 23 days.The urine was collect through catheter via sterile syringe for bacterial culture.The incidence of urinary tract infection,bacterial infection spectrum,composition ratio and bacteria distribution in 1,2 and 4 weeks after admission were recorded.Results Total urinary tract infection cases were 36(2.7％).There were 15 urinary tract infection cases in 625 famale cases(2.4％),There were 21 cases in 705 male cases (3.0％).49 pathogens were obtained,including 32 gram-negative bacilli (65.3％),17 gram-positive cocci (32.7％) and 1 fungus 2.0％.Enterococcus faecium (30.6％),E.coli (22.4％),Acinetobacter baumannii(10.2％),and Klebsiella pneumoniae (10.2％) were the predominant species.According to hospitalized time,the bacteria spectrum distribution showed Gram negative bacilli were 50.0％ (8 pathogens),57.1％ (4 pathogens),76.9％ (20 pathogens) and Gram positive bacteria were 43.8％ (7 pathogens),42.9％ (3 pathogens),23.1％ (6 pathogens) in the differet observed time point,respectively.A fungus was only observed in the first week after admission 6.3％.Concluusions Gram-negative bacilli were predominant bacterial of urinary tract infections in ICU patients.The incidence of fungus infection was low.E.coli,Acinetobacter baumannii and Klebsiella pneumoniae were the predominant species in Gramnegative bacilli.And Enterococcus faecium was the predominant specie in gram-positive cocci.It was similar for gram-negative bacilli and gram-positive cocci in the first two weeks.After two weeks Gram-negative bacilli turned to the main species.
