尿路感染病原菌的分布及药物敏感分析  

Distribution on etiological bacteria and drug sensitivity analysis in urinary tract infection

作　　者：肖观清[1,2] 孔耀中[1,2] 李导[1,2] 陈斌鸿[1,3] 叶佩仪[1,2] 邵咏红[1,2] 陈统清[1,2] 

机构地区：[1]广东省佛山市第一人民医院 [2]中山大学附属佛山医院肾内科,广东佛山528000 [3]中山大学附属佛山医院检验科

出　　处：《现代预防医学》2012年第22期5928-5930,5930,共3页Modern Preventive Medicine

摘　　要：目的了解泌尿系感染的病原菌分布及药物敏感性,为临床正确诊断、合理应用抗菌药物提供科学依据。方法按照《全国临床检验操作规程》要求操作,用法国生物梅里埃公司的VITEK-32细菌鉴定仪鉴定菌种,对临床尿液标本中分离的966株泌尿系感染病原菌进行鉴定。结果在分离的966株病原菌中,共有49个种类,其中革兰阴性菌675株占69.9%、革兰阳性菌183株占18.9%、真菌108株占11.2%;革兰阴性菌以大肠埃希菌为主,革兰阳性菌以粪肠球菌属为主,真菌以白色念珠菌为主。分离数在前7位的病原菌依次为大肠埃希菌(49.0%)、粪肠球菌(9.6%)、肺炎克雷伯菌(7.0%)、白色念珠菌(6.8%)、奇异变形杆菌(3.9%)、铜绿假单胞菌(3.3%)、表皮葡萄球菌(3.0%)。大肠埃希菌产ESBLs检出率为47.3%,肺炎克雷伯菌产ESBLs检出率为33.8%,耐苯唑西林凝固酶阴性葡萄球菌的检出率为37.5%,MRSA的检出率为50.0%。大肠埃希菌对头孢吡肟、头孢他啶、哌拉西林/他唑巴坦、阿米卡星、亚胺培南敏感性较好(70.6%～100%)。结论引起泌尿系感染病原菌的分布广泛,大肠埃希菌为泌尿系感染的主要病原菌。临床医生应重视细菌学培养,结合药物敏感试验和特殊耐药菌株的报告,合理使用抗菌药物以减少、减缓耐药菌株的产生和医院感染的暴发流行。OBJECTIVE To understand the distribution of etiological bacteria for urinary tract infection in the region and analyse drug sensitivity,and to provide a scientific basis for the correct and rational using antimicrobial drugs in clinical.METHODS Accordance with procedures of national clinical laboratory,we used the French company bioMérieux VITEK-32 identified strains of bacteria identification instrument to identify 966 of urinary tract infection pathogens which isolated from clinical urine samples.RESULTS 49 species were in the separation of 966 pathogens,and 675 gram-negative bacteria accounted for 69.9%;183 gram-positive bacteria accounted for 18.9%;108 fungi accounted for 11.2%;Escherichia coli bacteria was the main in the gram-negative bacteria;Gram-positive bacteria mainly belonged to Enterococcus faecalis;Candida albicans bacteria was the main in the fungi;Separation of the first seven bacteria were Escherichia coli(49.0%),Enterococcus faecalis(9.6%),Klebsiella pneumoniae(7.0%),Candida albicans(6.8%),Proteus mirabilis(3.9%),Pseudomonas aeruginosa(3.3%),Staphylococcus epidermidis(3.0%).The detection rate of ESBLs producing by Escherichia coli was 47.3%,and 33.8% by Klebsiella pneumoniae.The detection rate of oxacillin-resistant coagulase-negative staphylococci was 37.5%,and the detection rate of MRSA was 50.0%.The sensitivity of escherichia coli on cefepime,ceftazidime,piperacillin/tazobactam,amikacin,imipenem was good(70.6%-100%).CONCLUSION The pathogens of causing urinary tract infection are widely distributed,and escherichia coli are the major pathogens of urinary tract infection in the region.Clinicians should pay attention to bacteriological culture,combined with the drug susceptibility testing and drug-resistant strains of the special report,rational use of antibiotics to reduce drug-resistant strains and an outbreak of hospital infection.

关 键 词：尿路感染 病原菌 药物敏感 大肠埃希菌 

分 类 号：R446.5[医药卫生—诊断学]