慢性肾脏病患者尿路感染的病原菌分布特征及耐药性分析

doi:10.3969/j.issn.1671-7171.2025.12.010

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摘要 【目的】探讨慢性肾脏病(CKD)患者尿路感染的病原菌分布特征及耐药性。【方法】回顾性分析1413例CKD患者的资料,对患者尿液培养标本进行微生物鉴定及药敏试验,分析患者的感染特点及病原菌耐药情况。【结果】1413份标本中阳性标本223份,阳性率为15.78%;男性患者培养阳性率为15.37%(95/618),与女性患者的16.10%(128/795)比较,差异无统计学意义(P>0.05)。CKD尿路感染患者标本分离的革兰阴性菌(G^-)中大肠埃希菌最多,占23.39%,其次是肺炎克雷伯菌和粪肠球菌,分别占14.92%和13.71%。大肠埃希菌对头孢曲松和左氧氟沙星的耐药率均超过80.00%,肺炎克雷伯菌对左氧氟沙星的耐药率最高,为81.08%,患者均对亚胺培南和阿米卡星较敏感,耐药率低于10.00%;主要革兰阳性菌(G⁺)中粪肠球菌对头孢曲松耐药率,屎肠球菌对头孢他啶耐药率均为100.00%,两种主要G⁺对万古霉素和利奈唑胺无耐药性。【结论】引起CKD患者尿路感染的病原菌呈多样性,最常见的是大肠埃希菌。分离的病原菌表现出不同的耐药模式,临床应根据病原菌的耐药模式合理选择抗生素。

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关键词 ：肾疾病, 慢性病, 泌尿道感染, 革兰氏阴性菌, 革兰氏阳性菌, 真菌, 抗药性, 微生物

Abstract：【Objective】 To investigate the distribution characteristics and antibiotic resistance of pathogens causing urinary tract infections (UTIs) in patients with chronic kidney disease (CKD). 【Methods】 A retrospective analysis was conducted on 1413 CKD patients. Urine culture specimens were subjected to microbial identification and antibiotic susceptibility testing. The infection characteristics and drug resistance patterns of the pathogens were analyzed. 【Results】 Among the 1413 specimens, 223 were urine culture-positive, with a positive rate of 15.78%. The positive rate in male patients was 15.37% (95/618) and the positive rate in female patients was 16.10% (128/795), with no statistically significant difference between the two groups (P>0.05). Among the Gram-negative bacteria (G^-) isolated from CKD patients, Escherichia coli was the most common (23.39%), followed by Klebsiella pneumoniae (14.92%) and Enterobacter faecalis (13.71%). The resistance rates of E. coli to ceftriaxone and levofloxacin both exceeded 80.00%, while K. pneumoniae showed the highest resistance to levofloxacin (81.08%). Both pathogens remained highly sensitive to imipenem and amikacin, with resistance rates below 10.00%. Among the main Gram-positive bacteria (G⁺), Enterococcus faecalis exhibited 100.00% resistance to ceftriaxone, and Enterococcus faecium showed 100.00% resistance to ceftazidime. These two major G⁺ isolates were fully susceptible to vancomycin and linezolid. 【Conclusion】 The pathogens causing urinary tract infections in CKD patients are diverse, with Escherichia coli being the most common. The isolated pathogens exhibit varying resistance patterns, highlighting the importance of selecting antibiotics based on pathogen-specific resistance profiles in clinical practice.

Key words： Kidney Diseases Chronic Disease Urinary Tract Infections Gram-Negative Bacteria Gram-Positive Bacteria Fungi Drug Resistance, Microbial

收稿日期: 2024-10-18

中图分类号:

R692

基金资助:新疆维吾尔自治区基金项目(2022D01C313)

通讯作者: **E-mail:Lgq2330981@163.com

引用本文:

王霞, 禹霞, 王萍, 金星, 吕国庆. 慢性肾脏病患者尿路感染的病原菌分布特征及耐药性分析[J]. 医学临床研究, 2025, 42(12): 2050-2053.
WANG Xia, YU Xia, WANG Ping, et al. Distribution Characteristics and Antibiotic Resistance Analysis of Pathogens Causing Urinary Tract Infections in Patients with Chronic Kidney Disease. JOURNAL OF CLINICAL RESEARCH, 2025, 42(12): 2050-2053.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.12.010 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I12/2050

[1] WANG L M, XU X, ZHANG M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance[J].JAMA Intern Med,2023, 183(4): 298-310.
[2] 程桂青, 李晓, 周惠惠, 等. 尿路感染患者常见病原菌分布及耐药性分析[J].徐州医科大学学报, 2023, 43(7): 504-509.
[3] DOBREK Ł. Drug-related urinary tract infections[J].Wiad Lek,2021,74(7): 1728-1736.
[4] 朱晓艳, 易凡莉, 谢轶. 2010年-2021年四川大学华西医院透析与非透析慢性肾脏病患者临床感染及病原菌耐药特点分析[J].华西医学, 2022, 37(8):1170-1175.
[5] MOEIN M, GARN R M, SETTINERI J, et al. Urinary tract infection 1 year after kidney transplant: effect on kidney transplant outcomes[J].Exp Clin Transplant,2023, 21(7):556-561.
[6] SHIMIZU T, SUGIHARA T, KAMEI J, et al. Predictive factors and management of urinary tract infections after kidney transplantation: a retrospective cohort study[J].Clin Exp Nephrol,2021, 25(2):200-206.
[7] HSIAO C Y, LIN H L, LIN Y K, et al. Urinary tract infection in patients with chronic kidney disease[J].Turk J Med Sci,2014, 44(1): 145-149.
[8] 郑思强, 刘琳, 范神栋, 等. 尿路感染中常见病原菌及其特殊类型对抗菌药物的耐药情况[J].中华全科医学, 2023, 21 (11): 1852-1855.
[9] KUO I C, LEE J J, HWANG D Y, et al. Pyuria, urinary tract infection and renal outcome in patients with chronic kidney disease stage 3-5[J].Sci Rep,2020, 10(1): 19460.
[10] NESS D, OLSBURGH J. UTI in kidney transplant[J].World J Urol,2020, 38(1): 81-88.
[11] RODRĺGUEZ SÁNCHEZ M P, AFANADOR RUBIO D C, LUNA I M, et al.Impact of complicated urinary tract infection on renal graft function[J].Transplant Proc,2020, 52(4): 1173-1177.
[12] 杜雅丽, 胡爱玲, 衡媛, 等. 2018-2021年医院尿培养病原菌及菌株耐药性变迁[J].西北药学杂志, 2023, 38 (2): 208-211.
[13] PRADHAN B, PRADHAN S B. Prevalence of urinary tract infection and antibiotic susceptibility pattern to urinary pathogens in Kathmandu medical college and teaching hospital[J].Duwakot Birat J Health Sci,2017, 2(2):134-137.
[14] ZHOU L H, ZHAO H Z, CHEN Z Q, et al. Urinary tract aspergillosis in a patient with chronic kidney disease[J].BMJ Case Rep,2017, 2017: bcr2017221638.