泌尿系统感染患者的病原菌分布与耐药性分析  

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

作　　者：王日春[1] 许玲英[1] 赵丽丽[1] 方中飞 赵燕[2] 

机构地区：[1]浙江省海盐县人民医院检验科,浙江海盐县314300 [2]复旦大学附属上海金山医院检验科,上海200540

出　　处：《中华医院感染学杂志》2015年第17期3878-3880,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生研究基金资助项目(2014KYA105)

摘　　要：目的研究医院2013年泌尿系统感染患者病原菌分布及耐药性,为尿路感染的临床诊断和合理用药提供依据。方法收集2013年1-12月医院门诊及住院患者的尿液标本,采用VITEK-32型全自动细菌分析系统对送检标本进行菌株鉴定和药敏试验,并对结果进行分析。结果 2013年1-12月共收集患者尿液标本2 074份,分离出病原菌399株,检出率为19.2%;其中革兰阴性菌224株占56.2%,革兰阳性菌113株占28.3%,真菌62株占15.5%;革兰阴性菌对氨苄西林的耐药性较高,耐药率在73.9%~100.0%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢替坦、厄他培南、亚胺培南等较敏感,耐药率0~17.1%;革兰阳性菌对青霉素G、氨苄西林/舒巴坦、头孢替坦、氨曲南、克林霉素等高度耐药,耐药率〉96.00%,对利奈唑胺、万古霉素、替加环素高度敏感,耐药率〈1.30%;真菌对抗真菌药物敏感性相对较好。结论泌尿系统感染病原菌以革兰阴性菌为主,革兰阴性菌和革兰阳性菌的耐药性较严重,临床治疗应尽早进行病原学检测和药敏试验,减少经验性用药,合理选用抗菌药物,有效控制泌尿系统感染。OBJECTIVE To explore the distribution and drug resistance of the pathogens isolated from the patients with urinary system infections in 2013 so as to provide guidance for clinical diagnosis of urinary tract infections and reasonable use of antibiotics.METHODS From Jan 2013 to Dec 2013,the urine specimens were collected from the outpatient department patients and hospitalized patients.The pathogens isolated from the submitted specimens were identified by using VITEK-32 automatic bacterial analysis system,the drug susceptibility testing was performed,and the results were analyzed.RESULTS A total of 2 074 urine specimens were obtained from the patients from Jan 2013 to Dec 2013,and 399 strains of pathogens were isolated with the isolation rate of 19.2%,including224（56.2%）strains of gram-negative bacteria,113（28.3%）strains of gram-positive bacteria,and 62（15.5%）strains of fungi.The gram-negative bacteria were highly resistant to ampicillin,with the drug resistance rate ranging from 73.9% to 100.0%,while the strains were highly susceptible to cefoperazone-sulbactam,piperacillintazobactam,cefotetan,ertapenem,and imipenem,with the drug resistance rates ranging from 0to 17.1%.The gram-positive bacteria were highly resistant to penicillin G,ampicillin-sulbactam,cefotetan,aztreonam,and clindamycin,with the drug resistance rates more than 96.00%,while the strains were highly susceptible to linezolid,vancomycin,and tigecycline,with the drug resistance rates less than 1.30%.The fungi were relatively susceptible to antifungal agents.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the urinary system infections.The gram-negative bacteria and the gram-positive bacteria are highly drug-resistant.It is necessary for the hospital to carry out the etiological examination and the drug susceptibility testing as early as possible,reduce the empirical medication,and reasonably use antibiotics so as to effectively control the urinary system infections.

关 键 词：泌尿系统感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]