2015-2018年四川省细菌耐药监测网尿液标本细菌分布及耐药性分析  

Distribution and drug resistance of bacteria in urine samples of Sichuan Provincial Antimicrobial Resistant Investigation Net from 2015 to 2018

作　　者：龙姗姗[1] 喻华[1] 黄湘宁[1] 张凯[1] 钟敏[1] 刘爱波[1] LONG Shan-shan;YU Hua;HUANG Xiang-ning;ZHANG Kai;ZHONG Min;LIU Ai-bo(Sichuan Academy of Medical Sciences,Sichuan Provincial People's Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院检验科,四川成都610072

出　　处：《中华医院感染学杂志》2020年第7期1066-1071,共6页Chinese Journal of Nosocomiology

摘　　要：目的统计分析四川省细菌耐药监测网成员单位2015年-2018年度尿液标本细菌分布及耐药情况,为我省抗菌药物合理应用提供依据。方法采用四川省细菌耐药监测网数据合格的75家成员单位中,2015年-2018年门诊和住院患者临床尿液标本中分离的非重复病原菌,用标准纸片扩散法或自动化仪器检测法,测定监测药物对细菌的敏感性,并依据美国临床和实验室标准协会(CLSI)2018年标准,使用WHONET 5.6软件进行数据统计分析。结果按患者首次分离菌株进行统计分析,从尿液标本中分离出97663株病原菌,其中革兰阴性菌75635株占77.4%,革兰阳性菌22028株占22.6%,检出率前5位的病原菌依次是大肠埃希菌、屎肠球菌、肺炎克雷伯菌、粪肠球菌、铜绿假单胞菌。主要革兰阴性菌对碳青霉烯类抗菌药物耐药率较低,对头孢呋辛、头孢曲松、头孢噻肟耐药率较高。屎肠球菌和粪肠球菌对万古霉素、替考拉宁、利奈唑胺耐药率较低。未发现对万古霉素、利奈唑胺耐药的葡萄球菌。结论尿液标本病原菌多样化,以大肠埃希菌和肠球菌为主,临床应根据药敏结果合理用药,达到最佳治疗效果。OBJECTIVE To analyze the distribution and drug resistance of bacteria in urine samples of members of Sichuan Bacterial Resistance Monitoring Network from 2015 to 2018,and to provide evidence for rational use of antibiotics in Sichuan Province.METHODS The data was collected from 75 institutions in bacterial drug resistance monitoring network of Sichuan province during the year of 2015 to 2018.Pathogens non-repetitive were separated in the outpatient and inpatient clinical urine specimens by the standard disc diffusion method or automation instrument test.Drug sensitivity of bacteria was determined according to CLSI standard in 2018,and the data were statistically analyzed by using WHONET 5.6 software.RESULTS According to the firstly isolated strain in the patients,97663 strains of pathogenic bacteria were isolated from the urine specimens,including 75635 strains of gram-negative bacteria(77.4%)and 22028 strains of gram-positive bacteria(22.6%).The top 5 species of pathogens were Escherichia coli(51.5%),Enterococcus SPP(9.4%),Klebsiella pneumoniae(7.8%),Enterococcus faecalis(5.6%)and Pseudomonas aeruginosa(3.3%).The resistance rate of main gram-negative bacteria to carbapenems was lower than that of cefuroxime,ceftriaxone and cefotaxime.E.faecalis and E.faecalis had very low drug resistance to vancomycin,teicolanin and linezolid.No Staphylococcus resistance to vancomycin and linezolid was found.CONCLUSION The pathogens of urine specimens were diverse,and mainly were E.coli and Enterococcus.Clinical use of drugs should be based on the results of drug sensitivity to achieve the best therapeutic effect.

关 键 词：尿路感染 耐药率 药敏分析 监测 

分 类 号：R446.5[医药卫生—诊断学]