泌尿道感染病原菌分布及药敏性分析  

The distribution and drug susceptibility of pathogens causing urinary tract infections

作　　者：张恩[1] 李霞[1] 常燕子[1] 

机构地区：[1]宁波市医疗中心李惠利医院检验科,浙江宁波315040

出　　处：《中国微生态学杂志》2016年第9期1066-1068,1071,共4页Chinese Journal of Microecology

基　　金：宁波市科技计划项目(2012A610189)

摘　　要：目的分析并了解泌尿道感染病原菌的分布及药敏性,为临床合理有效的抗菌治疗提供参考依据。方法收集宁波市医疗中心李惠利医院2014年住院及门诊部送检的中段尿标本分离的1 187株病原菌,对其菌群分布和药敏结果进行回顾性分析。结果1 187株尿培养病原菌中,细菌占82.8%(983/1 187),真菌占17.2%(204/1 187)。检出率前四位的细菌分别是大肠埃希菌(31.2%)、屎肠球菌(10.5%)、肺炎克雷伯菌(9.6%)和粪肠球菌(9.2%),其中大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的阳性率分别是61.2%和26.9%,对头孢菌素类、青霉素类和单环酰胺类抗生素的敏感率普遍较低,对碳青霉烯类药物的敏感率>85%。屎肠球菌和粪肠球菌对抗菌药物的敏感性存在较大差异,且表现出较高的多药耐药性,屎肠球菌对万古霉素和利奈唑胺的敏感率分别为100.0%和95.1%,粪肠球菌对青霉素G和氨苄西林完全敏感。检出率前两位的真菌分别是白假丝酵母菌(9.0%)和光滑假丝酵母菌(6.2%),两者对5-氟胞嘧啶和两性霉素B近乎100.0%敏感。结论本院引起泌尿道感染的病原菌种类繁多,对不同抗菌药物的敏感性差异较大,临床应根据药敏试验结果权衡利弊后合理使用抗菌药物,预防和控制耐药菌株的形成。Objective To analyse and understand the distribution and drug susceptibility of pathogens causing urinary tract infections,and provide reference for rational and effective treatment.Methods The distribution and drug sensitivity of 1 187 strains of pathogens isolated from the urine specimens of hospitalized patients and outpatients in Lihuili Hospital in 2014 were retrospectively analyzed.Results Of the 1 187 strains,bacteria accounted for 82.8%（983/1 187）and fungi 17.2%（204/1 187）.The top four bacteria were Escherichia coli（31.2%）,Enterococcus faecium（10.5%）,Klebsiella pneumonia（9.6%）and Enterococcus faecalis（9.2%）.Extended-spectrumβ-lactamases（ESBLs）producing bacteria were found in61.2% of E.coli and 26.9% of K.pneumonia;the two bacteria showed a low susceptibility to penicillins,cephalosporins and monobactam,but a high susceptibility（〉85%）to carbopenems.The E.faecium and E.faecalis varied significantly in drug susceptibility,and showed a high multi-drug resistance.The sensitivity rate of E.faeciumto vancomycin and linezolid was 100.0% and 95.1%,respectively.E.faecalis was absolutely susceptible to penicillin G and ampicillin.The highest detection rate in fungi was 9.0%（C.albicans）,followed by 6.2%（C.glabrata）.The two fungi were almost 100% susceptible to 5-flucytosine and amphotericin B.Conclusion There are a great number of kinds of pathogens causing urinary tract infections,and their drug susceptibilities vary significantly.Clinicians should use antibiotics reasonably according to the results of drug sensitivity test,thus to prevent and control the emergence of drug resistant strains.

关 键 词：泌尿道感染 病原菌分布 抗菌药 敏感性 

分 类 号：R372[医药卫生—病原生物学]