5049份尿液微生物培养鉴定结果及耐药性分析  

The identification results and the analysis of drug resistance of 5049 urine microbial culture

作　　者：吴亚[1] 赵红丽 WU Ya;ZHAO Hong-li(Hebei Province Chinese Medicine Hospital Clinical Laboratory;Armed Police Hospital Clinical Laboratory Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]河北省中医院检验科,河北石家庄050000 [2]武警医院检验科,河北石家庄050000

出　　处：《中国实验诊断学》2021年第11期1617-1620,共4页Chinese Journal of Laboratory Diagnosis

基　　金：河北省中医药管理局课题(编号:2020024)。

摘　　要：目的通过回顾性分析医院尿路感染病原菌的分布和耐药性情况,为临床合理使用抗菌药物提供理论依据。方法收集医院2017-2018年中段尿标本进行培养,采用法国生物梅里埃公司VITEK-2Compact全自动细菌鉴定仪进行细菌鉴定和药敏试验;采用法国梅里埃ATB Express半自动细菌鉴定药敏仪进行真菌鉴定和药敏试验,结果用WHONET5.6软件进行数据统计分析。结果5049份尿标本中共分离出1439株细菌和假丝酵母菌,分离率为28.50%。病原菌以革兰阴性杆菌为主,占60.25%,假丝酵母菌占20.71%,革兰阳性球菌占19.04%。分离前3位菌株分别为大肠埃希菌(45.45%)、屎肠球菌(12.51%)、白假丝酵母菌(9.52%)。革兰阴性杆菌对氨苄西林、氨苄西林/舒巴坦、哌拉西林、一~三代头孢菌素类(头孢他啶除外)、庆大霉素、喹诺酮类药物、复方新诺明的耐药性较高,对哌拉西林/他唑巴坦、碳青霉烯类、阿米卡星抗菌药物较敏感,耐药率<20%;革兰阳性球菌对万古霉素、利奈唑胺敏感性高,粪肠球菌和凝固酶阴性葡萄球菌对呋喃妥因敏感性高于屎肠球菌。假丝酵母菌检出率较高,热带假丝酵母菌耐药性较其它假丝酵母菌高。结论在抗生素的选择压力下,耐药菌株和真菌二次感染逐渐增多,应合理使用抗菌药物,减少耐药菌株的产生和传播。Objective Through the retrospective analysis of the distribution and drug resistance of pathogens causing urinary tract infections,provide theoretical basis for clinical rational use of antimicrobial agents.Methods Collecting the middle urine specimen for culture from 2017 to 2018.The identification and drug sensitive test of isolated pathogens was carried out by using automatic bacteria identification system VITEK-2 Compact of BioMérieux,France;The ATB Express semi-automatic bacteria identification of BioMérieux,France was used to identify the fungi and do drug sensitive test.The software of WHONET 5.6 was used for statistical analysis.Results 1439 strains of bacteria and candida yeast were separatied from 5049 urine specimens.The separation rate was 28.50%.Gram-negative bacilli accounted for 60.25%of pathogenic bacteria,Candida accounted for 20.71%,Gram-positive coccus accounted for19.04%.The top three Separated strains were E.coli(45.45%),Excrement enterococcus(12.51%),White Candida(9.52%).Drug resistance of Gram-negative bacilli to Ampicillin,Ampicillin-sulbactam,Piperacillin,the first to the third generation of cephalosporin drugs(except Ceftazidime),Gentamycin,Guinolones and Trimethoprim-sulfamethoxazole was higher and to piperacillin-tazobactam,Carbon alkene drugs,Amikacin was lower(<20%).Gram positive coccus was sensitive to Vancomycin,Linezolid.Dung enterococcus and coagulase negative staphylococcus aureus were sensisiver to Nitrofurantoin than the excrement enterococcus.The detection rate of Candida was higher than before.The tropical candida resistance was higher than other candidas.Conclusion Under the selective pressure of antibiotics,drug resistant strains and secondary fungus infection were increasing.Rational use of antimicrobial agents may reduce the generation and spread of drug-resistant strains.

关 键 词：尿路感染 革兰阴性杆菌 革兰阳性球菌 假丝酵母菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]