ICU尿路感染患者菌群分布特征及耐药性分析  

Bacterial flora distribution characteristics in ICU patients with urinary tract infection and drug resistance analysis

作　　者：李毓龙 毛炜[1] 李阳超[1] LI Yulong;MAO Wei;LI Yangchao(Department of Clinical Laboratory,Jianyang Municipal People′s Hospital,Jianyang,Sichuan 641400,China)

机构地区：[1]四川省简阳市人民医院检验科

出　　处：《检验医学与临床》2019年第22期3293-3296,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨重症监护室(ICU)尿路感染患者病原菌的分布情况及耐药性,为临床选用抗菌药物提供依据。方法对2015年1月至2017年12月入住该院且符合《泌尿系感染诊断治疗指南2011版》的291例尿路感染患者清洁中段尿或导尿管尿液进行培养鉴定及药敏分析。结果共分离培养出病原菌306株,其中G(+)菌74株(24.2%),G(-)菌125株(40.8%),真菌107株(35.0%);G(+)菌中粪肠球菌、屎肠球菌耐药率大部分>45.0%;G(-)菌主要为大肠埃希菌34株(11.1%)、铜绿假单胞菌29株(9.5%)、奇异变形杆菌28株(9.2%),主要G(-)菌对亚胺培南、美罗培南、多黏菌素耐药率相对较低,差异有统计学意义(P<0.05);真菌以白色念珠菌(24.5%)为主,其中白色念珠菌、热带念珠菌及光滑念珠菌对氟康唑及伊曲康唑的耐药率均>12.0%。结论该院ICU尿路感染的主要病原菌为G(-)菌并有缓慢升高趋势,总体感染情况较为严重,病原菌耐药率高,应加强管理与监测。Objective To explore the distribution and drug resistance of pathogenic bacteria in the patients with urinary tract infection in ICU so as to provide the evidence for clinical selection of antibacterial drugs.Methods The clean middle-section urine or catheter urine from 291 patients with urinary tract infection admitted to this hospital and meeting the 2011 version of Guidelines for Diagnosis and Treatment of Urinary Tract Infection from January 2015 to December 2017 conducted the culture identification and drug susceptibility analysis.Results A total of 306 strains of pathogenic bacteria were isolated and cultured,including 74 strains(24.2%)of G(+)bacteria,125 strains(40.8%)of G(-)bacteria and 107 strains(35.0%)of fungi.Among G(+)bacteria,the resistance rates of Enterococcus faecalis and Enterococcus faecalis were generally>45.0%.G(-)bacteria were mainly Escherichia coli(34 strains,11.1%),Pseudomonas aeruginosa(29 strains,9.5%)and Proteus mirabilis(28 strains,9.2%),their resistance rates to imipenem,meropenan and polymyxin were relatively lower,the differences were statistically significant(P<0.05).Fungi were dominated by Candida albicans(24.5%),in which the drug resistance rates of Candida albicans,Tropical Candida and Smooth Candida to fluconazole and itraconazole were>12.0%.Conclusion The main pathogenic bacteria of urinary tract infection in ICU are G(-)bacteria,which have a slow increase trend.The overall infection situation is serious,the drug-resistance rate of pathogenic bacteria is high,and the management and monitoring should be strengthened.

关 键 词：重症监护室 尿路感染 病原菌 耐药率 

分 类 号：R446.5[医药卫生—诊断学]