泌尿系统感染患者病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens in patients with urinary system infection

作　　者：佟爱华[1] 孟祥红[1] 董梅[1] 匡铁吉[1] 何菊芳[1] 雷红[1] 宋海燕[1] 

机构地区：[1]解放军第309医院,北京100091

出　　处：《军医进修学院学报》2011年第5期455-457,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的了解临床泌尿系统感染患者病原菌分布及耐药情况,为临床合理使用抗菌药物提供指导。方法分析我院2008年1月-2009年12月从2 068份门诊和住院患者的中段尿标本中分离出的423株病原菌分布及耐药性。结果革兰阴性杆菌256株(60.5%),革兰阳性球菌132株(31.2%),真菌35株(8.3%)。主要致病菌为大肠埃希氏菌(36.7%)、肠球菌属(21.5%)、真菌(8.2%)、肺炎克雷伯氏菌(6.9%)、凝固酶阴性葡萄球菌(6.4%)和铜绿假单胞菌(5.9%);155株大肠埃希氏菌检出产超广谱-β-内酰胺酶(ESBL)73株(47.1%),38株肺炎克雷伯菌检出产ESBL 16株(41.2%);大肠埃希氏菌对亚胺培南100%敏感,肠球菌属和葡萄球菌属对万古霉素100%敏感,对多数检测药物的耐药率高于60%。结论泌尿系统感染病原菌耐药现象严重,应重视病原菌耐药性监测,规范临床合理使用抗菌药物。Objective To investigate the distribution and drug resistance of pathogens in patients with urinary tract infection in order to provide reference for the rational use of antibiotics in clinical practice.Methods Distribution and drug resistance of 423 pathogenic strains in mid-portion urine samples from 2 068 outpatients and inpatients with urinary tract infection from January 2008 to December 2009 in our hospital were analyzed retrospectively.Results Of the 423 pathogenic strains,256（60.5%） were Gram-negative bacilli,132（31.2%） were Gram-positive cocci,and 35（8.3%） were fungi.The main pathogens were Escherichia coli（36.7%）,Enterococcus spp.（21.5%）,fungi（8.2%）,Klebesiella pneumonia（6.9%）,CNS（6.4%）,and Pseudomonas aeruginosa（5.9%）.Of the 155 strains of Escherichia coli,73（47.1%） produced ESBL（＋）.The sensitivity of Escherichia coli to Imipenem was 100%.Of the 38 strains of Klebesiella pneumonia,16（41.2%） produced ESBL（＋）.The sensitive rate of positive cocci to Vancomycin was 100%.The drug resistance rate to most other antibiotics was over 60%.Conclusion The drug resistance of pathogens in patients with urinary tract infection is severe.Attention should be paid to the monitoring of their drug resistance.Standards should be made fro the rational use of antibiotics in clinical practice.

关 键 词：泌尿道感染 抗药性 细菌 

分 类 号：R691.3[医药卫生—泌尿科学]