急诊不同区域泌尿系病原菌分布及耐药性  

Clinical distribution and drug resistance of pathogens in urinary system in different regions of emergency department

作　　者：张烁[1] 孙立颖[2] 熊辉[1] ZHANG Shuo;SUN Li-ying;XIONG Hui(Department of Emergency,Peking University First Hospital,Beijing 100034,China;Department of Clinical Laboratory,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院急诊科,北京100034 [2]北京大学第一医院检验科,北京100034

出　　处：《中国临床药理学杂志》2023年第4期553-557,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 了解急诊不同区域患者泌尿系常见病原菌分布及耐药性,为临床抗菌药物合理使用及医院感染控制提供依据。方法 2018-07-01至2020-06-30急诊观察室、抢救室及监护室送检的尿液标本中分离出901株病原菌,根据纳入排除标准进行筛选后共纳入358株,采用BD Microflex Biotyer全自动快速生物质谱检测系统、VITEK2 COMPACT及PHOENIX100全自动细菌鉴定系统对菌株进行鉴定及药敏实验,并对结果进行分析。结果 本研究共检出革兰氏阴性菌15种,革兰氏阳性菌7种,真菌9种,其中革兰氏阴性菌检出率最高,其次为真菌和革兰氏阳性菌。3个区域病原菌检出率及总体分布差异无统计学意义。肺炎克雷伯菌对常见抗菌药物的耐药率均较高;大肠埃希菌对喹诺酮类耐药率高达80%,对β内酰胺类合剂、碳青霉烯类及阿米卡星耐药率较低;屎肠球菌对达托霉素、替加环素、奎奴普丁达福普汀全部敏感,可见万古霉素、利奈唑胺、替考拉宁耐药菌株,对其他常见抗菌药物高度耐药;本研究未发现耐药的白色念珠菌。3个区域内主要检出病原菌,即肺炎克雷伯菌、大肠埃希菌、屎肠球菌及白色念珠菌,对常见抗菌药物的耐药率差异无统计学意义。结论 急诊不同区域泌尿系病原菌分布差异无统计学意义;急诊不同区域内的主要检出病原菌对常见抗菌药物的耐药率差异无统计学意义。Objective To understand clinical distribution and drug resistance of pathogens in urinary system in Emergency department,and to provide foundation for clinical drug usage and infection control.Methods Form July 2018 to June 2020,901 urine culture positive specimen from observation room,resuscitation room and intensive care unit in emergency department were analyzed and 358 samples were finally included according to inclusion and exclusion criteria.Pathogens’ identification and drug susceptibility were performed by machines named BD Microflex Biotyer,VITEK2 COMPACT and PHOENIX100.We collected and analyzed the outcomes.Results 15 kinds of gram negative bacteria,7 kinds of gram positive bacteria and 9 kinds of fungi were sorted out.Most of them were gram negative bacteria,followed by fungi and gram positive bacteria.There was no statistical difference in pathogens’ detection rates or distribution among the three different areas.Klebsiella pneumoniae was resistant to most of the antibiotics;Escherichia coli’s resistant rate to Quinolone was as high as 80%,but was sensitive to Cephalosporins and β lactam combinations,Carbapenem and Amikacin;Enterococcus faecium was sensitive to Daptomycin,Tigecycline,Quinupristin/dalfopristin and a few bacteria were resistant to Vancomycin,Linezolid,Teicoplanin,and they all had a higher resistant rates to other drugs;Candida albicans was all sensitive strain.The main pathogens’ resistant rates to common drugs were not different among the three areas( that is Klebsiella pneumoniae,Escherichia coli,Enterococcus faecium and Candida albicans).Conclusion There was no statistical difference in urinary pathogens’ distribution in distinct areas of emergency department.Urinary pathogens’ resistant rates to common drugs had no statistical difference either in distinct areas of Emergency Department.

关 键 词：耐药性 病原菌分布 急诊科 泌尿系 

分 类 号：R446.5[医药卫生—诊断学]