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目的研究风湿性疾病中尿路感染大肠埃希菌对左氧氟沙星耐药性及相关危险因素。方法中国医科大学附属第一医院风湿免疫科2009年1月至2013年12月125株住院患者清洁中段尿培养所分离出大肠埃希菌,依据是否耐药分为两组。分析耐药组相关危险因素。结果 5年来大肠埃希菌对左氧氟沙星耐药率呈逐渐上升趋势。耐药组对氨苄西林、环丙沙星、头孢曲松、哌拉西林、复方新诺明的耐药率高于非耐药组,两组间差异有统计学意义(P<0.05)。慢性病程、既往喹诺酮类药物应用史、既往尿路感染、菌株产ESBLs为耐药危险因素。各风湿性疾病间耐药率比较差异未见统计学意义。结论风湿性疾病尿路感染危险因素与其他疾病尿路感染危险因素类似。临床工作中应加强对危险因素监视和控制。
Objective To study the drug resistance and related risk factors of urinary tract Escherichia coli to levofloxacin in rheumatic diseases. Methods The first stage hospital of China Medical University Department of Rheumatology and Immunology from January 2009 to December 2013 125 in-patient urine purification culture isolated Escherichia coli, according to whether the drug resistance divided into two groups. Analysis of resistance-related risk factors. Results The resistance rate of Escherichia coli to levofloxacin gradually increased over the past five years. The resistance rates to ampicillin, ciprofloxacin, ceftriaxone, piperacillin and cotrimoxazole in resistant group were higher than those in non-resistant group, with significant difference between the two groups (P <0.05). Chronic disease course, history of previous quinolones application, previous urinary tract infection, strains producing ESBLs are risk factors for drug resistance. There was no significant difference in the drug resistance rate between rheumatic diseases. Conclusions The risk factors for urinary tract infection in rheumatic diseases are similar to those in other diseases. Clinical work should strengthen the monitoring and control of risk factors.