尿路感染患者病原菌分布及其耐药性分析  

Distribution and drug resistance of pathogens causing urinary tract infections

作　　者：王宏儒[1] 鲍晓荣[1] 袁轶群[2] 

机构地区：[1]复旦大学附属金山医院肾内科,上海201508 [2]复旦大学附属金山医院检验科,上海201508

出　　处：《中华医院感染学杂志》2014年第8期1859-1861,共3页Chinese Journal of Nosocomiology

基　　金：上海市卫生局科研基金资助项目(2011-295)

摘　　要：目的调查医院门诊及住院患者尿路感染病原菌分布及其耐药性,为临床治疗尿路感染及合理使用抗菌药物提供依据。方法收集医院2012年2-12月门诊及住院患者清洁中段尿标本中分离出的312株病原菌,对检出病原菌采用K-B纸片扩散法进行鉴定及药物敏感性监测,结果按CLSI标准判读,数据采用SPSS 17.0软件进行统计分析。结果门诊患者尿液标本中检出病原菌58株,革兰阴性菌52株占89.7%、革兰阳性菌4株占6.9%、真菌2株占3.4%,居前3位的为大肠埃希菌、铜绿假单胞菌、奇异变形菌,分别占70.7%、8.6%、5.2%;病房患者尿液标本中检出病原菌254株,革兰阴性菌190株占74.8%、革兰阳性菌41株占16.1%、真菌23株占9.1%,居前3位的为大肠埃希菌、肺炎克雷伯菌、粪肠球菌,分别占44.9%、9.1%、7.9%;革兰阴性菌对青霉素类及头孢菌素类耐药率普遍较高,均>50.0%,革兰阳性菌对青霉素耐药率>50.0%。结论医院尿路感染病原菌仍以革兰阴性菌为主,病原菌对常用抗菌药物耐药率呈上升趋势,规范合理使用抗菌药物对治疗尿路感染具有重要意义。OBJECTIVE To investigate the distribution and drug resistance of pathogens causing urinary tract infec- tions in the hospitalized patients and the patients in outpatient department so as to guide the clinical treatment of urinary tract infections and the reasonable use of antibiotics. METHODS From Feb 2012 through Dec 2012, a total of 312 strains of pathogens were isolated from clean midstream urine specimens obtained from the patients in outpatient department and the hospitalized patients, then the isolated pathogens were identified with the use of K- B disk diffusion method, the drug susceptibility testing was performed, the result was interpreted by referring to CLSI criteria, and the data were statistically analyzed by means of SPSS 17.0 software. RESULTS Totally 58 strains of pathogens have been isolated from the urine specimens obtained from the patients in outpatient depart- ment, including 52 （89.7%） strains of gram-negative bacteria, 4 （6.9%） strains of gram-positive bacteria, and 2 （3.4%） strains of fungi% the Escherichia coli, Pseudomonas aeruginosa, and Proteus mirabilis ranked the top three species, accounting for 70. 7%, 8. 6%, and 5.2%, respectively. Totally 254 strains of pathogens have been isolated from the urine specimens obtained from the hospitalized patients, including 190 （74.8 %） strains of gram- negative bacteria, 41 （16.1%） strains of gram-positive bacteria, and 23 （9.1%） strains of fungi; the E. coli, Klebsiella pneumoniae, and Enterococcus faecalis ranked the top three species, accounting for 44. 9%, 9. 1%, and 7.9 %, respectively. The drug resistance rates of the gram-negative bacteria to penicillins and cephalosporins were more than 50.0% the drug resistance rate of the gram-positive bacteria to penicillin was more than 50.0%. CONCLUSION The gram-negative bacteria remain dominant among the pathogens causing the urinary tract infec- tions; the drug resistance rates of the pathogens to the commonly used antibiotics show upward trends. It is of great significance

关 键 词：尿路感染 门诊患者 住院患者 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]