泌尿系统感染常见病原菌分布与耐药性分析  

Analysis on the common pathogen distribution and drug resistance of urinary tract infection

作　　者：夏少梅[1] 林桢[1] 李婪[1] 周芸[1] 

机构地区：[1]广州医学院第二附属医院检验科,广东510260

出　　处：《检验医学与临床》2009年第19期1603-1605,共3页Laboratory Medicine and Clinic

摘　　要：目的分析临床泌尿系统感染常见病原菌分布及其耐药情况,指导临床合理使用抗菌药物。方法对2006年1月至2008年11月住院及门诊泌尿系统感染患者尿液培养中分离出的795株病原菌进行鉴定及体外耐药性试验,并对大肠埃希菌、肺炎克雷伯菌进行了超广谱β-内酰胺酶(ESBL)检测。结果泌尿系统感染患者标本共分离出病原菌795株,革兰阴性杆菌398株占50.1%,革兰阳性菌230株占28.9%,真菌167株占21.0%。主要致病菌依次为大肠埃希菌254株(31.9%)、真菌167株(21.0%)、粪肠球菌77株(9.7%)、屎肠球菌74株(9.3%)、肺炎克雷伯氏菌和铜绿假单胞菌各41株(5.2%)。ESBL确证试验:254株大肠埃希菌检出152株,产酶率59.8%;41株肺炎克雷伯菌检出32株,产酶率78.1%。病原菌分离率及耐药性呈上升趋势。结论大肠埃希菌、肠球菌、真菌是尿路感染的主要病原菌,临床分离的病原菌耐药现象严重,应加强规范使用抗菌药物的管理,重视细菌耐药性动态监测,对指导临床合理使用抗菌药物,控制耐药性菌株的播散,控制医院感染的发生与流行具有重要意义。Objective Reseach on the distribution of common pathogens and their resistance of the clinical urinary tract infection to guide clinical use of antimicrobial agents. Methods 795 pathogens were isolated from the urine culture of the out--patients and hospitalized patients with urinary tract infection from Jan. 2006 to Nov. 2008, and the pathogens were identified and put into vitro drug resistance testing, and Escherichia coli, Klebsiella pneumoniae was under the defection of super - extended-spectrum β-lactamase （ESBL）. Results Totally, 795 pathogens were isolated from the specimens of the patients with urinary tract infection, with 398 strains of gram negative bacilli, counted for 50.1%, 230 strains of Gram positive bacteria （28.9 %）, 167 strains of fungi counted for 21.0 %. The main pathogens were escherichia coli 254 （31.9%）, 167 fungus （21.0 %）, enterococcus faecalis 77 （9.7 % ）, enterococcus faecium 74 （9.3 % ）, klebsidla pneumoniae and 41 of the pseudomonas aeruginosa （5.2%）. ESBL confirmatory test： Of 254 escherichia coli, 152 were deteced out, with the enzyme production rate of 59.8% ; Of 41 Klebsiella pneumoniae, 32 were detected out, with the enzyme production rate of 78.1%. Pathogen isolation rate and the upward trend of drug resistance were increasing. Conclusion Escherichia coli, enterococci, fungus are the main pathogens of urinary tract infection, and drug resistance isolated from the clinic is in a very serious situation. Therefor, the proper use of antimicrobial agents should be strengthened, and attention should be paied to dynamic monitoring of bacterial resistance in guiding clinical rational use of antimicrobial drugs. It is of great importance in controling control the spread of drug resistance strains,and proventing the occurrence of infection in the hospital.

关 键 词：泌尿系感染 病原菌 微生物敏感性试验 细菌抗药性 

分 类 号：R691.3[医药卫生—泌尿科学]