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目的了解泌尿感染患者尿液标本细菌L型的检出情况,分析尿常规结果、病原菌分布情况及耐药性特点,为临床提供诊疗依据。方法对2014年1月至2015年12月1 532例住院和门诊泌尿感染患者的清洁中段尿标本的尿常规结果和微生物培养结果进行回顾性分析。严格按照《全国临床检验操作规程》要求采集患者尿液标本,2 h内完成尿液普通培养、高渗培养、尿常规检查及尿液离心后沉渣镜检。培养出细菌L型进行菌株鉴定和药敏试验,结果采用SPSS 13.0统计软件进行分析处理。结果共检出细菌L型132例,检出率为8.6%。132例细菌L型阳性病例中,白细胞酯酶阳性19例,阳性率14.4%;尿沉渣镜检白细胞阳性105例,阳性率79.5%。细菌L型检出率排名前三位的分别为大肠埃希菌、粪肠球菌、葡萄球菌,分别占40.9%、22.7%、12.1%。大肠埃希菌对氨苄西林、环丙沙星、左氧氟沙星、氨苄西林/舒巴坦、头孢唑啉、复方新诺明耐药率较高;粪肠球菌对克林霉素、奎奴普丁/达福普汀、红霉素、四环素耐药率较高;葡萄球菌对青霉素G、红霉素、头孢西丁、甲氧西林、环丙沙星耐药率较高。结论尿常规、尿沉渣镜检有助于细菌L型感染的辅助诊断,临床医生应根据尿培养结果合理、足疗程选用抗菌药物。
Objective To understand the detection of bacterial L - form in urinary samples from patients with urinary tract infection, and to analyze the results of urinalysis, the distribution of pathogens and the characteristics of drug resistance, so as to provide basis for clinic diagnosis and treatment. Methods The urinalysis results and microbial culture results of urine samples from 1 532 inpatients and outpatients with urinary tract infection from January 2014 to December 2015 were analyzed retrospectively. In accordance with the “National Clinical Laboratory Procedures” requirements of patients with urine samples collected within 2 h urine to complete the ordinary culture, hypertonic culture, urine routine examination and urine sediment microscopy. Bacterial L-type strains were identified for bacterial identification and susceptibility testing, the results using SPSS 13.0 statistical software for analysis and processing. Results A total of 132 cases of bacterial L type were detected, the detection rate was 8.6%. Of the 132 cases of bacterial L-positive cases, 19 cases were positive for leucocyte esterase, the positive rate was 14.4%; 105 cases were positive for urine leukocyte, the positive rate was 79.5%. Bacteria L-type detection rate of the top three were Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, accounting for 40.9%, 22.7%, 12.1%. Escherichia coli ampicillin, ciprofloxacin, levofloxacin, ampicillin / sulbactam, cefazolin, cotrimoxazole resistance rate higher; Enterococcus faecalis clindamycin, quinupristin / Da Fulptin, Erythromycin and Tetracycline were higher. Staphylococcus was more resistant to penicillin G, erythromycin, cefoxitin, methicillin and ciprofloxacin. Conclusion Urine routine urine sediment microscopy is helpful to the diagnosis of bacterial L infection. Clinicians should choose antibacterial drugs according to the urinary culture results.