尿液培养1188株病原菌及其耐药率分析  

Analysis of distribution of pathogens and drug resistance from 1188 cases of urine culture

作　　者：林涛[1] 唐朝贵[1] 李前辉[1] 张小云[1] 陈滢[1] 孙海平[1] 

机构地区：[1]南京医科大学附属淮安第一医院检验科,江苏淮安223300

出　　处：《中华临床医师杂志（电子版）》2014年第21期72-76,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的分析尿液细菌培养中病原菌分布与耐药情况,为临床合理选择抗生素提供依据。方法回顾性调查南京医科大学附属淮安第一医院2011年1月至2013年12月门诊及住院患者送检的3 271例尿液标本培养鉴定及药敏试验结果,并进行统计分析。结果 3 271例尿液标本共检出病原菌1 188株,总检出率为36.3%,其中革兰阴性菌799株,占67.3%,以大肠埃希菌为主,革兰阳性菌257株,占21.6%,以屎肠球菌为主,两者比较差异具有统计学意义（P〈0.05）;真菌132株,占11.1%,以白色念珠菌为主。大肠埃希菌对亚胺培南、呋喃妥因及哌拉西林/他唑巴坦有较高的敏感性,耐药率分别为0.4%、6.5%、13.9%,对喹诺酮类耐药率为75.3%～77.3%,对青霉素类和β-内酰胺类抗菌药物耐药率为45.9%～93.4%,超广谱β-内酰胺酶阳性的大肠埃希菌223株,占48.3%;屎肠球菌对万古霉素及氯霉素显示有较好的敏感性,耐药率分别为0.0%、11.4%,对其他抗菌药物耐药率均在57.1%～94.3%;白色念珠菌对常用抗真菌药物敏感性较高,耐药率最高为12.9%。结论泌尿道感染病原菌以大肠埃希菌、屎肠球菌及白色念珠菌为主,肠杆菌科细菌及肠球菌属对常用抗菌药物喹诺酮类及第三代头孢菌素耐药率较高,应重视泌尿道细菌感染的病原菌培养,加强抗菌药物的合理使用。Objective To investigate the distribution of pathogens and antibiotic resistant state in urinary tract infection, to provide reference for clinical rational use of antibiotics. Methods Review analysis was performed for 3 271 urine culture samples from Nanjing Medical University affiliated Huai＇an No. 1 hospital during 2011 to 2013. Statistical analysis was applied for the types and antibiotic resistance of 1 188 strains of pathogenic bacteria in urine culture positive. Results The total isolation rate of urine culture samples was 36.3%. In these positive cases, 799 strains of Gram negative bacteria were detected 67.3% and the most common was Escherichia coil There were 257 strains of C-ram positive bacteria 21.6% and the majority was Enterococcus. Significant difference was obtained in the strains of Gram negative bacteria and positive bacteria （P〈0.05）. Fungi occupied 11.1% among the strains of pathogenic bacteria in urine culture positive （132/I 188） and the majority was Candida albicans. Antimicrobial susceptibility tests showed the strains of Escherichia coli were susceptible to Imipcnem, Nitrofurantoin, and Pipcracillin/Tazobactam. The drug resistance rates of Eschcrichia coli to these antibiotics were 0.4%, 6.5%, and 13.9% separately. And the rates of drug resistance to other antibiotics were as follows： Qulnolones 75.3%-77.3%, Penicillin and β-lactams 45.9%-93.4%. Among all the strains of Eschcrichia coli, 223 cases were Extended-Spectrum Beta-Lactamase-Producing and the percentage was 48.3%. The strains of Enterococcus were susceptible to Vancomycin and Chloramphenicol, and the antibiotic resistance rates were 0.0% and 11.4%. The rates of drug resistance to other antibiotics were among 57. 1%-94.3%. A high sensitivity of the strains of Fungi to the common antifungal antibiotics was shown and the highest rate of drug resistance was only 12.9%. Conclusion Escherichia coli, Enterococcus and Fungi are the major pathogens in urinary tract infection. There are high rates of antibiotic resistance

关 键 词：泌尿道感染 尿液细菌培养 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]