慢性前列腺炎患者病原菌分布和耐药性分析

苗佩宏; 胡忠杰; 成杰; 陆建红

doi:10.3969/j.issn.2095-5227.2015.12.003

慢性前列腺炎患者病原菌分布和耐药性分析

Distribution and antibiotic resistance of pathogens isolated from patients with chronic prostatitis

摘要

摘要: 目的探讨武警浙江省总队医院慢性前列腺炎患者前列腺液中病原菌的分布特点及耐药状况，为临床治疗提供病原学依据。方法采集2013 - 2014年武警浙江省总队医院住院的378例慢性前列腺炎患者前列腺液标本，按常规进行细菌分离培养，对检出病原菌用Kirby-Bauer法进行药物敏感试验，进行菌种和耐药情况分析。结果 378份前列腺液标本中，病原菌阳性者253例，检出率为66.9%。其中革兰阳性球菌192株(75.9%)，主要为金黄色葡萄球菌86株(34.0%)，粪肠球菌40株(15.8%)，凝固酶阴性的葡萄球菌共66株(26.1%，主要是表皮葡萄球菌、溶血性葡萄球菌和其他葡萄球菌，依序分别占14.6%、5.1%和6.3%)；革兰阴性杆菌61例(24.1%)，以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌为主，分别为25株、17株、14株。药敏结果显示细菌对万古霉素、替考拉宁、利奈唑胺、左氧氟沙星的敏感率分别为100%、96.8%、100%、82.1%；革兰阴性菌对万古霉素、替考拉宁完全敏感，革兰阳性菌对亚胺培南完全敏感，对苯唑西林、氨苄西林、头孢西丁、红霉素、庆大霉素、头孢他啶、头孢噻肟均有一定程度耐药；金黄色葡萄球菌对喹诺酮类药左氧氟沙星比较敏感，粪肠球菌对临床常用的多种抗生素均较为敏感。结论本组慢性前列腺炎致病微生物分别为革兰阳性球菌、凝固酶阴性葡萄球菌、革兰阴性杆菌等，且出现多例混合感染，主要的病原菌对临床常用抗菌药物耐药性呈上升趋势。

Abstract: Objective To explore the species of pathogens in patients suffered from prostatitis and its antimicrobial susceptibility in vitro so as to offer a rational drug regimen in clinical practice． Methods All isolated pathogens were identified by Viteke-AMS-32 automatic microbiological analyzer and data statistical system． Results Three hundred and seventy-eight patients with chronic prostatitis were enrolled and succus prostaticus samples were cultured, totally 253 strains of microorganism were isolated with positive rate of 66．9%． Of the 253 strains of microorganism, 192 strains were gram-positive coccobacteria, accounting for 75．9%, including 86 strains of Staphylococcus aureus, accounting for 34．0%, 40 strains of Excrement intestines coccus (15．8%), and 66 coagulase-negative Staphylacocci, accounting for 26．1%, which mainly consisted of 37 strains of Staphylococcus epidermidis accounting for 14．6%． Other pathogenic bacteria included 13 strains of gram-positive Staphylococcus haemolyticus (5．1%), and 16 strains of other Staphylococcus (6．3%), respectively． Of the 61 strains of gram-negative bacteria (24．1%), it mainly consisted of Pseudomonas aeruginosa (25), Klebsiella pneumonia (17), and Escherichia coli (14)． The ratio of drug sensitivity of bacteria for vancomycin, teicoplanin, linezolid and levofloxacin were 100%, 96．8%, 100% and 82．1%, respectively． The gram-negative bacteria showed totally sensitive to vancomycin and teicoplanin, meanwhile the gram-positive bacteria showed totally sensitive to imipenem, but it presented different degree of resistance rate to oxacillin, ampicillin, cefoxitin, erythromycin, gentamycin, ceftazidime, and cefotaxime． Staphylococcus aureus showed more sensitive to levofloxacin, and excrement intestines coccus were sensitive to several commonly used antibiotics． Conclusion The pathogens causing chronic prostatitis infections in this research are gram-positive coccobacteria, coagulase-negative Staphylacocci, and gram-negative bacteria． Meanwhile some cases show mixed infections of pathogens mentioned above． The drug resistance rates of these pathogens demonstrate an increasing trend to commonly used antibiotics．

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