肾内科患者尿路感染病原菌分布及耐药性分析  

Investigation and study of the distribution and drug resistance of pathogens causing a urinary tract infection in patients in Nephrology

作　　者：谢鸣部 邹臻寰[2] 陈晶 黄智敏 陈吉琼 XIE Ming-bu;ZOU Zhen-huan;CHEN Jing;HUANG Zhi-min;CHEN Ji-qiong(Ningde Municipal Hospital Affiliated with Fujian Medical University,Ningde,Fujian,China 352100;First Hospital Affiliated with Fujian Medical University)

机构地区：[1]福建医科大学附属宁德市医院,福建宁德352100 [2]福建医科大学附属第一医院肾内科

出　　处：《中国病原生物学杂志》2020年第2期221-224,共4页Journal of Pathogen Biology

摘　　要：目的分析肾内科患者尿路感染病原菌分布及耐药性。方法医院收治的肾内科381例患者,通过尿培养分离病原菌,采用MicroScan WalkAway-40全自动微生物鉴定系统进行菌株鉴定,采用K-B纸片法进行耐药性检测,采用统计学分析患者感染特点。结果尿培养共分离170株病原菌,包括革兰阴性菌107株,革兰阳性菌49株,真菌14株,分别占62.94%、28.82%、8.24%。革兰阴性菌中,大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌及其他分别占24.12%、18.82%、15.88%、4.12%;革兰阳性菌中,粪肠球菌、金黄色葡萄球菌、表皮葡萄球菌、及其他分别占11.18%、8.24%、3.53%、5.88%;真菌中,白色假丝酵母菌、热带假丝酵母菌、光滑假丝酵母菌各占4.12%、2.94%、1.18%。革兰阴性菌对阿米卡星、氨曲南、环丙沙星、左氧氟沙星的耐药率分别为大肠埃希菌21.95%~53.66%,铜绿假单胞菌25.00%~59.38%,肺炎克雷伯菌29.63%~55.56%;革兰阳性菌对氨苄西林、左氧氟沙星、环丙沙星、青霉素、庆大霉素耐药率分别为粪肠球菌42.11%~63.16%,金黄色葡萄球菌28.57%~57.14%、,表皮葡萄球菌33.33%~66.67%;对万古霉素敏感。男、女性患者感染率分别为62.50%和50.43%,差异具有统计学意义(χ^2=4.8772,P<0.05);<50岁患者和≥50岁患者的感染率分别为48.52%和66.98%,差异具有统计学意义(χ^2=13.2277,P<0.05);有基础疾病和无基础疾病患者感染率分别为66.34%和50.28%,(χ^2=10.1001,P<0.05);住院时间≥15d和<15d患者感染率分别为63.45%和51.05%,差异具有统计学意义(χ^2=5.6661,P<0.05)。结论大肠埃希菌和粪肠球菌是肾内科患者感染的主要革兰阴性菌和革兰阳性菌,对常用抗生素有不同程度的耐药性,因此应重视对细菌的耐药性检测,为临床合理用药提供参考。Objective To investigate the distribution and drug resistance of pathogens causing a urinary tract infection in patients in Nephrology in order to guide the clinical prevention and treatment of infections. Methods A urine culture was used to isolate pathogens from 381 patients in Nephrology at this Hospital.Strains were identified by the MicroScan WalkAway-40 automated microbial identification system,and drug resistance was determined using the K-B disk method.The characteristics of infection were statistically analyzed. Results A total of 170 pathogens were isolated from urine culture,including 107 strains of Gram-negative bacteria(62.94%),49 strains of Gram-positive bacteria(28.82%),and14 strains of fungi(8.24%).Gram-negative bacteria included Escherichia coli(24.12%),Pseudomonas aeruginosa(18.82%),Klebsiella pneumoniae(15.88%),and other bacteria(4.12%).Gram-positive bacteria included Enterococcus faecalis(11.18%),Staphylococcus aureus(8.24%),S.epidermidis(3.53%),and other bacteria(5.88%).Fungi included Candida albicans(4.12%),C.tropicalis(2.94%),and C.glabrata(1.18%).The resistance of Gramnegative bacteria to amikacin,aztreonam,ciprofloxacin,and levofloxacin ranged from 21.95-53.66%.The resistance of Gram-positive bacteria to ampicillin,levofloxacin,ciprofloxacin,penicillin,and gentamicin ranged from 42.11-63.16%.The resistance of S.aureus ranged from 28.57-57.14% and the resistance of S.epidermidis ranged from 33.33-66.67%;both were sensitive to Vancomycin.The rate of infection was 62.50%in male patients and 50.43%in female patients;the rate of infection differed significantly by sex(χ^2=4.877 2,P<0.05).The rate of infection was 48.52%in patients<50 years of age and 66.98%in patients≥50 years of age;the rate of infection differed significantly by age(χ^2=13.227 7,P<0.05).The rate of infection was 66.34%in patients with an underlying illness and 50.28%in patients with without an underlying illness(χ^2=10.100 1,P<0.05).The rate of infection was 63.45%in patients hospitalized≥15 days illness and 51.05%in

关 键 词：肾内科患者 尿路感染 病原分布 耐药情况 

分 类 号：R378[医药卫生—病原生物学]