泌尿系感染患者中段尿培养病原菌种类分布及耐药性  

Distribution and drug resistance of pathogenic bacteria in middle stage urinary culture of patients with urinary infection

作　　者：许士芝 Xu Shizhi(Department of Microbiology Room,the First People's Hospital of Tancheng County,Linyi 276100,Shandong,China)

机构地区：[1]郯城县第一人民医院微生物室,山东临沂276100

出　　处：《实用检验医师杂志》2024年第1期47-50,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的 分析泌尿系感染(UTI)患者中段尿培养病原菌种类分布及耐药性。方法 选择2022年10月—2023年2月郯城县第一人民医院收治的150例UTI患者作为研究对象,采集所有受检者的中段尿液样本,进行病原菌培养及耐药试验,并对UTI患者的科室分布、病原菌培养及耐药试验结果进行分析。结果 150例UTI患者中,58例(占38.67%)来自泌尿外科,34例(22.67%)来自肾内科,21例(14.00%)来自重症监护病房(ICU)。在150例UTI患者提供的中段尿液样本中共分离出病原菌163株,其中革兰阴性(G^(-))杆菌108株(占66.26%),革兰阳性(G^(+))菌42株(占25.77%),真菌13株(占7.98%)。G^(-)菌以大肠埃希菌(占63.89%)和肺炎克雷伯菌(占17.59%)为主,G^(+)菌以粪肠球菌(占47.42%)和屎肠球菌(占19.05%)为主。大肠埃希菌对氨苄西林、诺氟沙星、复方新诺明的耐药率均较高,分别为95.65%、86.96%、52.17%;肺炎克雷伯菌对氨苄西林、诺氟沙星的耐药率较高,分别为100.00%、68.42%;粪肠球菌对红霉素、呋喃妥因、万古霉素的耐药率较高,分别为52.38%、90.48%、57.14%;屎肠球菌对氨苄西林、环丙沙星、左氧氟沙星、红霉素、青霉素、万古霉素菌均存在极高的耐药性,达到100.00%。结论 UTI的主要病原菌为G^(-)菌,其中以大肠埃希菌和肺炎克雷伯菌最常见,不同病原菌的耐药性不同,在治疗过程中建议结合病原菌耐药性试验结果选择抗菌药物,以提升治疗效果。Objective To analyze the distribution and drug resistance of pathogenic bacteria in middle stage urinary culture of patients with urinary tract infection(UTI).Methods The 150 cases of UTI patients admitted to the First People's Hospital of Tancheng County from October 2022 to February 2023 were selected as research objects.The middle stage urine samples were collected for pathogen culture and drug resistance test.The department distribution,pathogen culture and drug resistance test results of UTI patients were analyzed.Results Among the 150 UTI patients,58 cases(38.67%)came from urology department,34 cases(22.67%)from nephrology department,and 21 cases(14.00%)from intensive care unit(ICU).A total of 163 strains of pathogenic bacteria were isolated from the middle stage urine samples provided by 150 patients with UTI,including 108 strains of Gram negative(G^(-))bacteria(66.26%),42 strains of Gram positive(G^(+))bacteria(25.77%),and 13 strains of fungi(7.98%).The G^(-)bacteria were mainly Escherichia coli(63.89%)and Klebsiella pneumoniae(17.59%),while the G^(-)bacteria were mainly Enterococcus faecalis(47.42%)and Enterococcus faecium(19.05%).Escherichia coli had high resistance to ampicillin,norfloxacin and compound sulfamethoxazole(95.65%,86.96%and 52.17%).Klebsiella pneumoniae had high resistance to ampicillin and norfloxacin(100.00%and 68.42%),while Enterococcus faecalis had high resistance to erythromycin,furantoin and vancomycin(52.38%,90.48%and 57.14%).Enterococcus faecium had extremely high resistance to ampicillin,ciprofloxacin,levofloxacin,erythromycin,penicillin and vancomycin,all reaching 100.00%.Conclusions The main pathogens of UTI are G^(-)bacteria,among which Escherichia coli and Klebsiella pneumoniae are the most common.Different pathogens have different drug resistance.It is recommended to choose antibiotics based on the results of pathogen resistance test during the treatment process to improve the treatment effect.

关 键 词：泌尿系感染 尿培养 病原菌 耐药性 

分 类 号：R691.3[医药卫生—泌尿科学] R446.5[医药卫生—外科学]