2009-2015年泌尿系感染病原菌种类构成及耐药性变迁  

Distribution and drug resistance of pathogens causing urinary tract infections in a hospital from 2009 to 2015

作　　者：解泽强[1] 陈亮[1] 张曼[1] 

机构地区：[1]北京大学第九临床医学院,首都医科大学附属北京世纪坛医院临床检验中心,尿液细胞分子诊断北京市重点实验室,北京100038

出　　处：《中华医院感染学杂志》2017年第13期2991-2994,共4页Chinese Journal of Nosocomiology

基　　金：北京市医管局首届登峰人才计划基金资助项目(DFL20150701)

摘　　要：目的了解泌尿系感染常见病原菌分布及耐药性,为临床抗菌药物使用及医院感染控制提供可靠依据。方法收集医院2009年1月-2015年12月分离的泌尿系感染病原菌4296株,采用Microscan Walkway 40分析系统和VITEK-2compact全自动药敏鉴定分析仪对菌株进行鉴定及药敏试验,并对结果进行分析。结果 4296株病原菌中,革兰阴性菌2476株占57.64%,革兰阳性菌1169株占27.21%,真菌651株占15.15%;分离率占前五位的分别为大肠埃希菌1098株(25.56%)、屎肠球菌570株(13.27%)、肺炎克雷伯菌380株(8.85%)、铜绿假单胞菌349株(8.12%),粪肠球菌300株(6.98%);碳青霉烯类对大肠埃希菌保持了较好的抗菌活性,但对铜绿假单胞菌、肺炎克雷伯菌出现了较高的耐药性,其耐药率分别为2.0%、41.2%、39.47%;屎肠球菌对各种抗菌药物的耐药率明显高于粪肠球菌,耐万古霉素的屎肠球菌和粪肠球菌检出率分别为38.9%、3.3%。结论医院泌尿系感染病原菌以革兰阴性菌为主,细菌耐药性监测能够对临床合理使用抗菌药物提供依据。OBJECTIVE To understand the distribution and drug resistance of common species of pathogens causing urinary tract infections so as to provide reliable basis for clinical use of antibiotics and control of nosocomial infections.METHODS A total of 4296 strains of pathogens causing urinary tract infections were collected from the hospital between Jan 2009 and Dec 2015.The pathogens were identified by using Microscan Walkway 40 analysis system,the drug susceptibility testing was carried out with the use of VITEK-2compact,and the result was analyzed.RESULTS Among the 4296 strains of pathogens,there were 2476（57.64%）strains of gram-negative bacteria,1169（27.21%）strains of gram-positive bacteria,and 651（15.15%）strains of fungi.The top 5species of isolated pathogens were in turn as the following：Escherichia coli（1098strains,25.56%）,Enterococcus faecium（570strains,13.27%）,Klebsiella pneumoniae（380strains,8.85%）,Pseudomonas aeruginosa（349strains,8.12%）,and Enterococcus faecalis（300strains,6.98%）.Carbapenems maintained high antibacterial activity against the E.coli strains,however,the P.aeruginosaand K.pneumoniae strains were highly resistant to carbapenems,and the drug resistance rates were 2.0%,41.2%,and 39.47%,respectively.The drug resistance rate of the E.faeciumstrains was remarkably higher than that of the E.faecalis strains to the antibiotics.The isolation rates of vancomycin-resistant E.faeciumand E.faecalis were 38.9%and 3.3%,respectively.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the urinary tract infections in the hospital.The monitoring of drug resistance may facilitate the reasonable clinical use of antibiotics.

关 键 词：泌尿系感染 耐药性 抗菌药物 

分 类 号：R691.3[医药卫生—泌尿科学]