郑州大学第一附属医院2016年4026株尿培养病原菌的分布及耐药性分析  

Distribution and antibiotic resistance of 4 026 pathogens causing urinary tract infections in the First Affiliated Hospital of Zheng Zhou University,2016

作　　者：苟建军[1] 刘娜[1] 郭小兵[1] 任益慧 田富云[1] 饶玉婷[1] GOU Jian - jun;LIU Na;GUO Xiao - bing;REN Yi - hui;TIAN Fu - yun;RAO Yu - ring(Department of Clinical Laboratory, the First Affiliated Hospital of ZhengZhou University ,Zheng zhou ,Henan 450052, Chin)

机构地区：[1]郑州大学第一附属医院检验科,河南郑州450052

出　　处：《现代预防医学》2018年第9期1674-1678,共5页Modern Preventive Medicine

基　　金：河南省科技厅科技攻关项目(162102310509)

摘　　要：目的了解郑州大学第一附属医院尿培养病原菌分布及其耐药性,为临床治疗尿路感染提供依据。方法收集郑州大学第一附属医院2016年1-12月临床分离的尿培养病原菌4 026株,采用法国BioMerieux的Vitek-2全自动分析仪进行细菌鉴定及药敏试验,ESBLs菌株按CLSI 2014规定的标准采用双纸片确认法。结果共分离出4 026株病原菌,其中革兰阴性菌2 448株,占60.80%;革兰阳性菌1 017株,占25.26%;真菌561株,占13.93%。尿路感染病原菌检出率泌尿外科占46.05%,产ESBLs的大肠埃希菌和肺炎克雷伯杆菌对氨苄西林、哌拉西林的耐药率大于95%,对头孢曲松、头孢噻肟、头孢唑啉的耐药率在90%左右,但对碳青霉烯类抗菌药物耐药率分别低于6.94%、16.49%。粪肠球菌对氨苄西林、环丙沙星、呋喃妥因、青霉素G的耐药率<3%,屎肠球菌对氨苄西林、喹诺酮类药物、红霉素、青霉素G的耐药率>90%,但二者均对利奈唑胺和万古霉素100%敏感。结论本院2016年尿路感染病原菌以革兰阴性菌为主,泌尿外科尿路感染问题严峻,产ESBLs的大肠埃希菌和肺炎克雷伯杆菌分离率较高。Objective To access the distribution and drug resistance of the pathogens in the urine culture in the First Affiliated Hospital of ZhengZhou University,so as to provide the evidence for the treatment for urinary tract infection. Methods 4 026 pathogens in the urine culture clinically isolated were collected between January and December of 2016 in the First Affiliated Hospital of ZhengZhou University. The bacteria identification and susceptibility test were performed by the French Bio Merieux Vitek-2 automatic analyzer,and the double-disk synergy test was performed to conform ESBLs-producing strains by Clinical and the Laboratory Standards Institute 2014（CLSI2014）. Results A total of 4 026 strains of pathogens were isolated,including 2 448 Gram-negative bacteria（60. 80%）,1017 Gram-positive bacteria（25. 26%） and 561 fungi（13. 93%）.The detection rate of pathogenic bacteria in urinary tract infection in the Department of Urology was 46. 05%. The resistance rates of Escherichia coli and Klebsiella pneumoniae producing ESBLs to ampicillin and piperacillin were more than 95%,to ceftriaxone,cefotaxime,cefazolin were about 90%,while to carbapenem were less than 6. 94% and 16. 49%,respectively. The resistance rates of Enterococcus faecalis to ampicillin,ciprofloxacin,furantoin and penicillin G were less than 3%,while the resistance rates of Enterococcus faecium to ampicillin,erythromycin,quinolone and penicillin G were more than 90%. The drug sensitivity of Enterococcus faecalis and Enterococcus faecium to linezolid and vancomycin were both 100%. Conclusion Gram-negative bacteria are the main pathogenic bacteria contributing to urinary tract infection in the First Affiliated Hospital of Zheng Zhou University in 2016. The problem of urinary tract infection in the Department of Urology is severe and the isolation rate of Escherichia coli and Klebsiella pneumonia that producing ESBLs is high.

关 键 词：尿路感染 病原菌 耐药性 抗菌药物 

分 类 号：R117[医药卫生—公共卫生与预防医学]