2007-2013年浙江萧山医院分离自尿路感染患者的葡萄球菌种属分布及药物敏感性分析  

Distribution and drug resistance of Staphylococcus from patients with urinary tract infection in Zhejiang Xiaoshan Hospital,2007- 2013

作　　者：郭远瑜[1] 王红旗[1] 楚旭[1] 沈利蒙[1] 董华丽[1] 毛剑锋[1] 张传领[1] 

机构地区：[1]浙江萧山医院,浙江杭州311202

出　　处：《疾病监测》2015年第3期228-232,共5页Disease Surveillance

摘　　要：目的调查分离自尿路感染患者中葡萄球菌的菌种、临床分布及耐药性，为临床合理选用抗菌药物提供依据。方法尿液采用经典型浸片Uricult培养，VITEK-60全自动微生物分析仪进行细菌鉴定和药物敏感实验，利用WHONET5．6软件对浙江萧山医院2007年1月至2013年12月从尿培养中分离的菌株进行回顾性分析。结果共分离葡萄球菌284株，检出居前3位的细菌分别为表皮葡萄球菌118株（41．5％）、溶血葡萄球菌49株（17．3％）和金黄色葡萄球菌40株（14．1％）。菌株主要来源于内科106株（37．3％），其次泌尿外科89株（31．3％）；耐药率前4位的是青霉素、氨苄西林／舒巴坦、苯唑西林和红霉素（〉173．3％），耐药率较低的是利奈唑胺、万古霉素、奎奴普丁／达福普汀、利福平、呋喃妥因和莫西沙星（0．0％～16．4％），MRS检出率为75．9％；2007年与2013年相比，耐药率上升较为明显的是莫西沙星和克林霉素，下降较多的有苯唑西林、庆大霉素、左氧氟沙星、红霉素、复方新诺明和四环素。结论尿路感染患者分离的葡萄球菌种类达15种，其中以表皮葡萄球菌为主；呋喃妥因适合作为治疗尿路感染的经验用药，定期监测和分析尿路感染的病原菌分布及耐药性，有助于提高临床经验治愈率及合理用药水平。Objective To investigate the distribution and drug resistance of Staphylococcus in patients with urinary tract infection in our hospital, and provide evidence for the rational use of antibiotics in hospitals. Methods The urine specimens collected from January 2007 to December 2013 were cultured in Uricult, VITEK-60 automatic analyzer was used for strain identification and drug susceptibility test, and a retrospective analysis was carded out on the urine culture results with software WHONET 5.6. Results A total of 284Staphylococcus strains were detected, in which 118 Staphylococcus epidermidis （ 41. 5% ） , 49 Staphylococcus haemolyticus （ 17. 3% ） and 40 Staphylococcus aureus （14.1%） ranked first to third. The Staphylococcus strains were mainly detected in internal medicine department （106 strains, 37.3% ）, followed by urology department （89 strains, 31.3% ）. The resistance rates of staphylococcus were high to penicillin, ampicillin/sulbactam, oxacillin and erythromycin （ t〉 73.3% ）, and low to linezolid, vancomycin, quinupristin/dalfopristin, rifampin, nitrofurantoin and moxifloxacin （0.0% -16.4% ）. The detection rate of MRS was 75.9%. Compared with 2007, the resistant rates to moxifloxacin and clindamycin increased obviously in 2013, but the resistant rates to oxacillin, gentamicin, levofloxacin, erythromycin, sulfamethoxazole and tetracycline declined. Conclusion Staphylococcus epidermidis was major pathogen to cause with urinary tract infection; Nitrofurantoin is suitable for experiential treatment of urinary tract infection. It is important to regularly monitor the distribution and drug resistance of the pathogens causing urinary tract infection in order to guide clinical antibiotic use.

关 键 词：尿路感染 葡萄球菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]