泌尿系感染的病原菌分布及耐药性分析  

Pathogens in Urinary System: Their Destribution and Resistance Analysis

作　　者：赵建平[1] 周艳萍[2] 白晓红[1] 李风娥[1] 杨国香[1] 

机构地区：[1]内蒙古自治区医院,内蒙古呼和浩特010017 [2]包头铝厂集团职工医院,内蒙古包头014046

出　　处：《中华医院感染学杂志》2004年第3期350-352,共3页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区科学技术攻关资助项目(990 12 2;2 0 0 0 0 2 11)

摘　　要：目的　了解泌尿系感染患者的病原菌分布及耐药性 ,指导临床合理用药。方法　从尿标本中分离出 6 70株(男性 2 17株 ,女性 4 5 3株 )病原菌进行耐药性分析 ,特殊耐药株如 MRS株、VRE株、HL AR株、产 ESBL s细菌的检测及体外药敏试验均采用 K- B法。结果　分离前 5位的细菌依次为大肠埃希菌 (占 5 4 % )、凝固酶阴性葡萄球菌 (6 % )、肺炎克雷伯菌 (5 % )、铜绿假单胞菌 (4 % )、弗氏柠檬酸杆菌 (4 % ) ;产 ESBL s细菌的检出率为 11.6 % ,MRSCON株为 74 .3% ,VRE株为 2 8.9% ,HL AR株为 70 .3% ;大肠埃希菌对阿米卡星、呋喃妥因和 β-内酰胺类抗生素 (青霉素类除外 )敏感性较好 (72 %～ 97% ) ,对喹诺酮类抗生素较差 (16 %～ 18% )。结论　大肠埃希菌为泌尿系感染的主要病原菌 ,占 >5 0 % ;女性患者明显高于男性 ;过去常用于治疗泌尿系感染的喹诺酮类抗生素 ,耐药性较高 ;临床应结合药敏试验和特殊耐药株的报告结果 ,合理选择抗生素。OBJECTIVE To investigate the distribution and drug resistance of the pathogens in the patients who suffered from the urinary infection, then help the clinic to use drug rationally. METHODS A total of 670 bacteria were isolated from the urine and given resistance analysis (men 217 strains, women 453 strains). The test and extra corporeal antimicrobial agents susceptibility took K-B method which was used for special resistant strains such as MRS, VRE, HLAR and the ESBLs-produced bacteria. RESULTS The first 5 were Escherichia coli (54%), coagulase negative staphylococcus (6%), Klebsiella pneumoniae (5%), Pseudomonas aeruginosa (4%), and Citrobacter freundii (4%). The rate of test was different, ESBLs-produced bacteria were 11.6%, MRSCON 74.3%, VRE 28.9%, HLAR 70.3%. E. coli was sensitive to amikacin, nitrofurantoin and beta-lactam antibiotics (except penicillin) (72-97%), but less sensitive to quinolones antibiotics (16-18%). CONCLUSIONS More than half of the urinary pathogens is E. coli; women are more significant than men. Quinolones antibiotics which we used before have high resistance, so the clinic should consider the antimicrobial agent susceptibility and special resistant strain test report and choice drug rationally.

关 键 词：病原菌 大肠埃希菌 耐药性 医院感染 

分 类 号：R691.3[医药卫生—泌尿科学]