尿培养病原菌分布及耐药性分析  

Distribution of urine culture pathogens and analysis of drug resistance

作　　者：邓燕燕 唐之俭 王芳 于晓然[2] 费凤英 

机构地区：[1]中山医院青浦分院检验科,上海201700 [2]大连市友谊医院呼吸科,辽宁大连116100

出　　处：《中华医院感染学杂志》2014年第17期4191-4193,共3页Chinese Journal of Nosocomiology

基　　金：辽宁省科技厅自然科学基金资助项目(201202053)

摘　　要：目的了解医院门诊和住院患者尿培养中病原菌分布及耐药性，为临床治疗提供参考依据。方法651株病原菌分离自2011年1月－2012年12月医院门诊和住院患者的尿液标本，采用MicroScan WalkAway-plus全自动微生物鉴定和药敏分析系统进行菌株鉴定和药敏试验，采用WHONET5．6软件进行统计分析。结果共分离病原菌651株，检出排前3位依次为大肠埃希菌、粪肠球菌、凝固酶阴性葡萄球菌，分别占46．2％、16．6％、8．5％；301株大肠埃希菌中有219株产超广谱β－内酰胺酶（ESBLs），占72．8％；大肠埃希菌对阿莫西林／克拉维酸、阿米卡星、亚胺培南较为敏感，耐药率为12．0％、9．O％和1．3％；132株肠球菌属中发现2株耐万古霉素肠球菌（VRE），均为粪肠球菌，万古霉素对这两株VRE的MIC为32～326mg／L，粪肠球菌和屎肠球菌对万古霉素和利奈唑胺的耐药率均较低；分离的凝固酶阴性葡萄球菌（CNS）中，最常见的是表皮葡萄球菌占50．9％；55株CNS中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率为65．5％，CNS对呋喃妥因、克林沙星、利奈唑胺、利福平、万古霉素较敏感。结论临床应根据尿培养药敏结果合理应用抗菌药物，控制耐药率的上升。OBJECTIVE To investigate the distribution and drug resistance of pathogens obtained from urine culture of outpatients and hospitalized patients so as to provide reference basis for clinical treatment. METHODS A total of 651 pathogens were isolated from the urine specimens of the outpatients and hospitalized patients from Jan 2011 to Dec 2012, MicroScan WalkAway-plus full-automatic identification and drug sensitivity analyzers were adopted for bacteria identification and drug sensitivity test, and WHONET 5.6 software was adopted for statistical analysis. RESULTS A total of 651 strains of pathogens were isolated with the top 3 pathogens of Escherichia coli （E. coil） （46.2%）, Enterococcus faecalls（E, faecalis） （16.6%） and coagulase negative Staphylococcus（8.5%）. 219 of 301 E. coli strains produced extended spectrum β-lactamase （ESBLs）, accounting for 72.8%. E. coli was sensitive to amoxicillin-clavulanic acid, amikacin and imipenem, with drug resistance rates of 12. 0%, 9. 0% and 1.3 % ; 2 of the 132 strains of Enterococcus were discovered to be vancomycin-resistant Enterococci（VRE）, which were all E. faecalis; the minimum inhibitory concentration （MIC） of vancomycin to the 2 strains of VRE varied from 32 to 326 mg/L; the drug resistance rates of E. faecalis and Enterococcus faecium （E. faecium）to vancomycin and linezolid were all low. Among the isolated coagulase negative Staphylococcus （CNS）, the common Staphylococcus epiderrnidis（S, epiderrnidis） accounted for 50.9%; among the 55 strains of CNS, the detection rate of methicillin resistant coagulase negative Staphylococcus（MRCNS） was 65.5 %; CNS was sensitive macrodantin, clinafloxacin, linezolid, rifampin, and vancomycin. CONCLUSION It is necessary to reasonably use antibiotics in accordance with the urine culture and drug sensitivity test results to prevent the rising of drug resistance rate.

关 键 词：尿培养 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]