医院泌尿道感染病原菌分布及耐药性分析  

Analysis of pathogens and antibiotic resistance in nosocomial urinary tract infections

作　　者：叶文君[1] 黄琴香[1] 丁玎[1] 

机构地区：[1]温州医学院附属温岭医院,浙江温岭317500

出　　处：《中国预防医学杂志》2010年第4期394-396,共3页Chinese Preventive Medicine

摘　　要：目的了解医院泌尿道感染病原菌的分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法收集医院泌尿道感染患者尿液标本中分离的156株病原菌,进行细菌鉴定和药敏分析,并对大肠埃希菌和肺炎克雷伯菌进行超广谱β-内酰胺酶(ESBLs)的检测。结果医院泌尿道感染的病原菌主要为革兰阴性(G-)菌72株(46.15%)、其次是真菌55株(35.26%)、革兰阳性(G+)菌29株(18.59%);前5位菌株依次为大肠埃希菌、热带念珠菌、白色念珠菌、粪肠球菌和肺炎克雷伯菌;产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为57.50%、73.33%;病原菌对常用抗菌药物产生多重耐药,G-菌对多黏菌素B 100%敏感,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、呋喃妥英、碳青酶烯类的敏感率>80.0%,氨卞青霉素、环丙沙星的耐药率>80.0%;G+菌对万古霉素、利奈唑烷100.0%敏感,青霉素G的耐药率>80.0%。结论重视泌尿道感染病原菌及耐药性检测,以药敏试验选用抗菌药物进行治疗十分重要。Objective To study the distribution and antibiotic resistance of pathogens in nosocomial urinary tract infection and to provide evidence for administration of antibiotics.Methods A total of 156 pathogen strains were isolated from urine samples of patients with nosocomial urinary tract infection.Bacteria were identified and drug sensitivity analysis was conducted.Production of extended-spectrum β-lactamase（ESBLs）was tested for isolates of Escherichia coli and Klebsiella pneumoniae.Results The major pathogens of nosocomial urinary tract infection were Gram-negative（G-） bacteria（n=72,46.15%）,followed by fungi（n=55,35.26%） and Gram-positive（G＋）bacteria（n=29,18.59%）.The most common strains isolated were Escherichia coli,Candida tropicalis,Candida albicans,Enterococcus faecalis and Klebsiella pneumoniae in sequence.The proportions of ESBLS production were 57.50% and 73.33% for Escherichia coli and Klebsiella pneumoniae respectively.Pathogens had drug resistance to multiple common antibiotics.The sensitivity rate of G-bacteria was 100.0% to polymyxin B,and was higher than 80.0% to cefoperazone/ sulbactam,piperacillin/tazobactam,furantoin,carbapenems,ampicillin and ciprofloxacin respectively.The sensitivity rate of G＋ bacteria was 100.0% to vancomycin and oxazolidinone antibiotics respectively,and was higher than 80.0% to penicillin G.Conclusion Drug resistant strain of pathogens played an important role in urinary tract infection.The results suggested that drug sensitivity test was critical in antibiotics selection for the treatment.

关 键 词：泌尿道感染 病原菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学] R691.3[医药卫生—临床医学]