尿培养阳性标本的病原菌分布及耐药性分析  

Distribution and antibiotic resistance of pathogen isolated from mid-stream urine of 354 patients

作　　者：罗军[1] 李红霞[1] 蒋文强[1] 王菲[1] 

机构地区：[1]四川省绵阳市中心医院检验科,621000

出　　处：《检验医学与临床》2012年第23期2930-2931,共2页Laboratory Medicine and Clinic

摘　　要：目的分析四川省绵阳市中心医院2011年1～12月尿路感染病原菌的分布及耐药情况,为临床合理选用抗菌药物提供依据。方法采用法国生物梅里埃Vitek Compact 2全自动细菌鉴定系统对细菌进行鉴定,用琼脂稀释法进行药物敏感试验,双纸片表型确证试验检测产超广谱β-内酰胺酶(ESBLs)菌株。结果 354株病原菌中以革兰阴性杆菌为主,占80.79%,其中优势菌株为大肠埃希菌(55.08%);革兰阳性球菌以屎肠球菌为主,占4.24%。大肠埃希菌除对亚胺培南全部敏感外,对其他抗菌药物均表现出不同程度的耐药。195株大肠埃希菌中,产ESBLs 108株,检出率为55.38%。屎肠球菌对高浓度的链霉素和高浓度的庆大霉素敏感率很高,分别为93.3%和100%。结论该院尿路感染的致病菌以大肠埃希菌为代表的革兰阴性杆菌为主,但肠球菌等革兰阳性球菌所占比例比2010年有所增多。细菌对多种抗菌药物耐药,临床应按药敏试验结果合理选择抗菌药物。Objective To analyze the distribution and antimicrobial resistance of pathogenic bacteria in urinary tract infection（UTI） so as to provide evidence for appropriate selection of antimierobial agents in clinical practice. Methods 354 strains of pathogenic bacteria isolated from urine samples were evaluated by the system of Bio-Merieux VITEK COMPACT 2. Drug susceptibility test was performed with the agar dilution method,and ESBLs were detec- ted by double paper phenotype corroborate test. Results Among 354 strains of pathogenic bacteria, most of them were gram-negative bacilli, accounting for about 80. 790//00, of which predominant strains was Escherichia coil （55.08 % ）. The predominant strain of gram-positive bacteria was Enterococcus faecium, accounting for 4.24 %. All of 195 strains of Escherichia coli were sensitive to imipenem , but to other antimicrobial agents show the different degree resistant rates . ESBLs had detected in 108 strains of Eseherichia coli, the detection rates for 55. 380//00 . Drug suscep- tibility o{ enterococcus {aecium to high concentration gentamycin and high concentration streptomycin respectively was 100.0% and 93. 3%. Conclusion The predominant bacteria of UTI are still gram-negative bacteria, main of which is Escherichia coil But gram-positive bacteria has increased in recent years. Bacteria are resistant to a variety of antibiotics. Approximate selection of antibiotics in clinical practice should be made on the basis of susceptibility test results.

关 键 词：尿路感染 耐菌药物 抗药性 病原菌 

分 类 号：R181.34[医药卫生—流行病学]