男性良性前列腺增生患者尿中最常分离细菌及其对抗生素的体外敏感性

V. Vuksanović, N. Terzić, D. Vujošević
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摘要

良性前列腺增生(BPH)和相关的下尿路症状通常影响老年男性。在波德戈里察,几乎一半(47.5%)的男性前列腺增生病例尿液培养呈阳性,其中14.2%为多重感染。尿路感染最常见于71至80岁年龄组。尽管两组男性(有和没有BPH)都更容易发生尿路革兰氏阴性细菌感染,但与没有BPH的男性相比,有BPH的男性中肺炎克雷伯菌明显更常见。结果表明,男性前列腺增生患者的治疗要比非前列腺增生男性复杂得多,因为在治疗过程中,有许多菌株对左氧氟沙星耐药(革兰氏阴性菌对左氧氟沙星的耐药水平为80.4%,其中肺炎克雷伯菌耐药率为89.7%,埃希菌耐药率为73.3%)。革兰氏阳性菌的耐药水平为24.8%,其中肠球菌耐药菌株占64.7%)和β-内酰胺类抗生素(53.4%的分离革兰氏阴性菌合成ESBL酶,其中肺炎克雷伯菌高达89.7%)。男性前列腺增生患者革兰氏阳性菌和革兰氏阴性菌的多重耐药菌株分别为53.1%和79.7%。碳青霉烯类药物仍然是一组储备药物,对93.2%的前列腺增生男性尿路感染有良好的治疗效果。
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Most Commonly Isolated Bacteria in Urine and their In Vitro Sensitivity to Antibiotics in Men with Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms commonly affect older men. Men with BPH in Podgorica in almost half (47.5%) cases have positive urine culture, out of which 14.2% have polyinfection. Urinary tract infections are most common in the age group 71 to 80 years. Although both groups of men (with and without BPH) are more prone to gram-negative bacterial infections of the urinary tract, K. pneumoniae is significantly more common in men with BPH compared with men without BPH. The results indicate that treatment of men with BPH is much more complex than in men without BPH due to the fact that in the treatment, a number of strains are resistant to levofloxacin (resistance of gram-negative bacteria to levofloxacin at the level of 80.4%, with 89.7% of resistant strains of K. pneumoniae and 73.3% of E . coli strains, as well as resistance of gram-positive bacteria at level of 24.8%, with resistant strains of enterococci in 64.7% of the strains) and β-lactam antibiotics (53.4% of isolated gram-negative bacteria synthesize ESBL enzymes out of which K. pneumoniae in up to 89.7% of the strains). Also, men with BPH have multi drug resistant strains in 53.1% of gram-positive bacteria and 79.7% of gram-negative bacteria. Carbapenems still represent a reserve group of drugs that have a good therapeutic effect in 93.2% of urinary tract infections in men with BPH.
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