403例尿培养分离病原菌的耐药性监测  

Monitoring of drug resistance of pathogens isolated from urine specimens of 403 patients

作　　者：李晖婷[1] 刘霞[1] 蔡小华[1] 

机构地区：[1]中山大学附属第一医院黄埔院区检验科,广东广州510700

出　　处：《中华医院感染学杂志》2013年第9期2236-2238,共3页Chinese Journal of Nosocomiology

摘　　要：目的监测并分析2007-2011年尿分离菌菌种分布及耐药性,为临床治疗尿路感染提供流行病学依据。方法回顾性分析医院2007-2011年尿标本分离菌的菌种分布和药敏率,采用WalkAway系统进行细菌鉴定及药敏试验,酵母菌鉴定采用API系统。结果共分离出403株病原菌,前5位病原菌依次为大肠埃希菌130株占32.3%、肺炎克雷伯菌28株占6.9%、粪肠球菌27株占6.7%、铜绿假单胞菌24株占6.0%、屎肠球菌21株占5.2%;大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)检出率分别为62.3%和53.6%;粪肠球菌对氨苄西林和呋喃妥因耐药率分别为7.7%和11.1%;未发现万古霉素和利奈唑胺的耐药株。结论大肠埃希菌为泌尿系感染的主要病原菌;酶抑制剂复合制剂可作为大肠埃希菌感染的经验用药;氨苄西林和呋喃妥因可用于粪肠球菌尿路感染经验治疗。OBJECTIVE To monitor and analyze the antimicrobial resistance and the distribution of the species of pathogens isolated from the urine specimens from 2007 to 2011 so as to provide epidemiological basis for the clinical treatment of urinary tract infections.METHODS The distribution of the species of pathogens isolated from the urine specimens from 2007 to 2011 and the drug susceptibility rates were retrospectively analyzed.WalkAway system or API system was applied to identify the bacteria and fungi.RESULTS A total of 403 strains of pathogens were isolated,there were 130（32.3%） strains of Escherichia coli,28（6.9%） strains of Klebsiella pneumonia,27（6.7%） strains of Enterococcus faecalis,24（6.0%） strains of Pseudomonas aeruginosa 24 6.0%,and 21（5.2%） strains of E.faecium.The detection rates of the extended spectrum β-lactamase（ESBLs）-producing E.coli and ESBLs-producing K.pneumoniae were 62.3% and 53.6%,respectively.The antimicrobial resistance rates of E.faecalis to ampicillin and nitrofurantoin were 7.7% and 11.1%,respectively.No strains of E.faecalis or E.faecium resistant to vancomycin and linezolid were found.CONCLUSION E.coli is the predominant species of pathogens causing urinary tract infections,β-lactamase inhibitor compound preparation can be recommended as an empirical drug to treat E.coli infections.Ampicillin and nitrofurantoin can be used for the empirical treatment of urinary tract infections caused by E.faecalis.

关 键 词：尿培养 尿路感染 病原菌 耐药监测 

分 类 号：R378[医药卫生—病原生物学]