Derevianko I I, Khodyreva L A
Antibiot Khimioter. 1997;42(9):27-32.
The main pathogens of inflammatory diseases of the kidneys and upper urinary tracts in inpatients of an urological unit were gramnegative organisms of the family Enterobacteriaceae while the pathogens of the infection of the lower urinary tracts (nonspecific urethritis) and male genitalia were grampositive cocci. Pseudomonas aeruginosa, Enterobacter agglomerans and Proteus spp. (indole positive) were the chief causative agents of the hospital infections. The analysis of the materials revealed a tendency towards an increase in the microflora resistance to the most widely used antibiotics: aminoglycosides, cephalosporins and fluoroquinolones. This especially applied to the "problem" pathogen P.aeruginosa. Thus, in 1987 the portion of the P.aeruginosa gentamicin susceptible strains amounted to 52 per cent whereas in 1996 it was 13 per cent. The strains susceptible to ofloxacin equaled 79 per cent in 1988 and 44 per cent in 1995. At present the drugs of choice in the treatment of urinary tract infections due to P.aeruginosa are ceftazidime, cefpirome and amikacin (65, 64 and 62 per cent of the susceptible strains respectively). The importance of permanent microbiological monitoring and the respective correction of the therapy are indicated.
泌尿外科住院患者肾脏和上尿路炎症性疾病的主要病原体是肠杆菌科革兰氏阴性菌，而下尿路（非特异性尿道炎）和男性生殖器感染的病原体是革兰氏阳性球菌。铜绿假单胞菌、聚团肠杆菌和变形杆菌属（吲哚阳性）是医院感染的主要致病菌。对相关材料的分析显示，微生物对最广泛使用的抗生素（氨基糖苷类、头孢菌素类和氟喹诺酮类）的耐药性有增加趋势。这在“问题”病原体铜绿假单胞菌上表现得尤为明显。因此，1987年铜绿假单胞菌对庆大霉素敏感的菌株比例为52%，而在1996年为13%。对氧氟沙星敏感的菌株在1988年为79%，在1995年为44%。目前，治疗由铜绿假单胞菌引起的尿路感染的首选药物是头孢他啶、头孢匹罗和阿米卡星（敏感菌株分别占65%、64%和62%）。这表明了持续进行微生物监测以及相应调整治疗方法的重要性。
