泌尿系感染3062株分离菌的分布及耐药性  

The distribution and drug resistance of 3,062 isolates from urinary system infections

作　　者：江丹英 林雪峰[1] 王兵勇[1] 陈静[1] 

机构地区：[1]温州医科大学附属乐清医院检验医学中心,浙江温州325600

出　　处：《中国微生态学杂志》2016年第5期550-554,共5页Chinese Journal of Microecology

基　　金：温州市医药卫生科学研究项目(2015A17)

摘　　要：目的分析泌尿系感染分离菌的分布及耐药特征,为临床合理使用抗菌药物提供依据。方法对2012年至2014年3 062株泌尿系感染患者尿培养标本中分离出的菌株,采用西门子公司的WalkAway96全自动微生物分析仪及配套试剂进行菌种鉴定和药敏试验,并对部分肠杆菌科菌株进行产ESBLs酶和产KPC型碳青霉烯酶检测,对葡萄球菌进行耐甲氧西林检测,应用WHONET 5.6软件进行数据统计分析。结果 3 062株分离菌中,革兰阴性菌1 701株(55.6%),革兰阳性菌740株(24.2%),真菌621株(20.3%),检出率最高的前3位分离菌依次为大肠埃希菌、粪肠球菌和白假丝酵母,分别占36.8%、9.0%和8.0%。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌产ESBLs酶检出率分别为54.0%、44.3%和21.1%,金黄色葡萄球菌和凝固酶阴性葡萄球菌的耐甲氧西林菌株检出率分别为32.4%和83.1%。革兰阴性菌对多数抗菌药物均有不同程度的耐药性,肠杆菌科细菌对头孢菌素类与β-内酰胺酶抑制剂复合物相对较低,对碳青霉烯类耐药率最低。革兰阳性球菌对利奈唑胺和万古霉素的耐药性较低。结论泌尿系感染分离菌分布广泛,大部分菌株具有多药耐药性,临床上应根据药敏结果合理用药。Objective To analyze the distribution and drug resistance of the pathogens causing urinary system infections,so as to provide evidence for reasonable clinical application of antibacterial agents.Methods 3,062 bacterial strains isolated from the urine specimens of patients with urinary system infections from 2012 to 2014were collected.WalkAway96full-automatic microbiology analyzer and the matching reagents（Siemens）were adopted to conduct strain identification and drug sensitivity test.Some of the enterobacterium strains were detected for ESBLs and KPC type carbapenemase,and Staphylococcus strains were detected for the resistance to methicillin.WHONET 5.6was used to conduct data statistical analysis.Results Among the 3,062 isolates,there were 1,701strains（55.6%）of gram-negative bacteria 740strains（24.2%）of gram-positive bacteria,and 621strains（20.3%）of fungi.The top 3pathogens with the highest detection rates were Escherichia coli（36.8%）,Enterococcus faecalis（9.0%）and Candida albicans（8.0%）.The positive rate of ESBLs-producing strains in Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were54.0%,44.3% and 21.1%respectively.The positive rate of methicillin-resistant strains in Staphylococcus aureus and coagulase negative staphylococci were 32.4% and 83.1% respectively.Gram-negative bacteria had different degrees of drug resistance to most antibacterial agents.Enterobacteriaceae had a relatively lower drug resistance to cephalosporins and beta-lactamase inhibitor compound,and had the lowest drug resistance to carbapenems.Gram-positive bacteria had relatively lower drug resistance to Linezolid and Vancomycin.Conclusion The pathogens causing urinary system infections are widely distributed,and most of them have multidrug resistance.Antibiotic drugs should be used according to drug sensitivity results.

关 键 词：泌尿系感染 分离菌 耐药 

分 类 号：R378[医药卫生—病原生物学]