353例泌尿外科住院患者尿培养分离病原菌分布及耐药性监测  

Distribution and drug resistance of pathogens isolated from urine specimens of 353 patients with urinary tyust infection

作　　者：程波[1] 程勇[1] 杨海帆[1] 何启丹[1] 姜睿[1] 

机构地区：[1]泸州医学院附属医院泌尿外科,泸州646000

出　　处：《泸州医学院学报》2013年第6期597-600,共4页Journal of Luzhou Medical College

摘　　要：目的:监测并分析我院泌尿外科尿路感染病原菌的菌种分布及耐药性,为临床治疗尿路感染、合理选用抗菌药物提供流行病学依据。方法:回顾性分析泸州医学院附属医院泌尿外科2012年6月至2013年9月间尿培养标本中分离菌的菌种分布和药敏率。细菌鉴定及药敏试验采用MicroScan WalkAway系统并辅以手工方法。结果:共分离出353株病原菌。其中,革兰阴性菌245株,占69.4%;革兰阳性菌96株占27.2%;真菌12株,占3.4%。前5位病原菌依次为大肠埃希氏菌163株,占46.2%;粪肠球菌39株,占11.0%;肺炎克雷伯氏菌20株,占5.7%;产酸克雷伯氏菌15株,占4.2%;屎肠球菌14株,占4.0%。大肠埃希菌产超广谱β-内酰胺酶(ESBLs)检出97例,检出率为59.5%,肺炎克雷伯氏菌产超广谱β-内酰胺酶(ESBLs)检出7例,检出率为35.0%;未发现万古霉素和利奈唑胺的耐药株。结论:泌尿道感染病原菌仍以大肠埃希菌为主,酶抑制剂复合制剂可作为大肠埃希菌感染的经验用药。细菌耐药率较高,临床医师应根据药敏结果合理选用敏感抗菌药物,减少耐药菌株的产生。Objective： To analyze the drug resistance and distribution of pathogens isolated from urine specimens for the reasonable use of antibiotics in clinical treatment of urinary tract infections. Methods： The distribution and drug sensitivity of bacteria isolated from urine culture specimens from 2012.6 to 2013.12 in our department of urology, assessed via MicroScan WalkAway system supplemented by manual methods, were retrospectively analyzed. Results： A total of 353 strains of pathogens were isolated, including 245 strains of gram negative bacteria （69.4%）, 96 strains of gram positive bacteria （27.2%） and 12 strains of fungi （3.4%）. The top 5 pathogens were Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Klebsiella oxytoca and Enteroeoccus feces, accounting for accounted for 46.2%, 11.0%, 5.7%, 4.2% and 4.0% respectively. 97 cases （59.5%） of Escherichia coli and 7 cases （35%） of Klebsiella pneumoniae producing extended spectrum beta lactamases （ESBLs） were detected. No vancomycin and linezolid resistant strains were found. Conclusion： E.eoli remains the main species of pathogens causing urine tract infections in our hospital. Compound ^-lactamase inhibitor preparations may be recommended as an empirical drug for the treatment of E.coli infections. Drug resistance is serious. The reasonable use of antibiotics should be based on the drug sensitivity results to reduce drug-resistance.

关 键 词：尿路感染 尿培养 病原菌 病原菌耐药监测 

分 类 号：R446.129[医药卫生—诊断学]