尿路感染患者病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens isolated from patients with urinary tract infections

作　　者：赵彩萍 周茂亮[2] 胡晓燕[2] 

机构地区：[1]浙江省磐安县计划生育指导站,浙江磐安县322300 [2]浙江省磐安县人民医院检验科,浙江磐安县322300

出　　处：《中华医院感染学杂志》2015年第14期3170-3172,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金资助项目(2013KYA220)

摘　　要：目的了解尿路感染病原菌分布及对常用抗菌药物的耐药性,为临床医师合理使用抗菌药物提供科学依据。方法回顾性调查分析2011年1月-2013年12月医院门诊和住院的708例尿路感染患者尿液标本检出的病原菌分布及药敏试验结果,采用法国生物梅里埃公司生产的ATB New微生物分析系统及配套试剂进行细菌鉴定与药敏试验。结果共分离出708株病原菌,以革兰阴性杆菌为主,占56.1%,大肠埃希菌居所有病原菌的首位,占31.5%;革兰阴性杆菌特别是产ESBLs株对常用抗菌药物耐药率普遍较高,但对亚胺培南、美罗培南、阿米卡星仍保持敏感,耐药率均<40.0%;革兰阳性球菌对青霉素、大环内酯类抗菌药物呈高度耐药>90.0%,对利奈唑胺、米诺环素、夫西地酸、呋喃妥因的耐药率较低,均<20.0%;未发现耐万古霉素葡萄球菌和肠球菌。结论尿路感染病原菌呈现多样性且耐药性较高,加强对尿路感染病原菌的耐药监测,对指导临床合理使用抗菌药物具有重要意义。OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing urinary tract infections so as to provide scientific basis for reasonable clinical use of antibiotics.METHODS From Jan 2011 to Dec2013,totally 708 outpatients and inpatients with urinary tract infections were included in the study,then the distribution of the pathogens isolated from the urine specimens and the results of the drug susceptibility testing were retrospectively analyzed,and the bacterial identification and the drug susceptibility testing were performed by using ATB New microorganism analysis system of BioMerieux,France and supporting reagents.RESULTS A total of 708 strains of pathogens have been isolated,and the gram-negative bacilli were dominant,accounting for56.1%;Escherichia coli ranked the first place among all the pathogens,accounting for 31.5%.The gram-negative bacilli,especially the ESBLs-producing strains,were highly resistant to the commonly used antibiotics,but remained susceptible to imipenem,meropenem,and amikacin,with the drug resistance rate less than 40.0%.The drug resistance rates of the gram-positive cocci to penicillin and macrolides were more than 90.0%,while the drug resistance rates to linezolid,minocycline,fusidic acid,and furantoin were less than 20.0%.The vancomycin-resistant Staphylococcus or Enterococcus strain was not found.CONCLUSION The pathogens causing the urinary tract infections show diversity and are highly drug-resistant.It is of great significance in the reasonable clinical use of antibiotics to strengthen the surveillance of the drug resistance of the pathogens causing the urinary tract infections.

关 键 词：尿路感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]