2021-2023年某三甲医院尿路感染病原菌分布及其耐药性分析  

Pathogenic spectrum of urinary tract infections and drug resistance in a grade A territory hospital from 2021 to 2023

作　　者：时洛洛 王玉月[1] SHI Luo-luo;WANG Yu-yue(Department of Clinical Laboratory,the Third Affiliated Hospital of Soochow University,Jiangsu Changzhou 213003)

机构地区：[1]苏州大学附属第三医院检验科,江苏常州213003

出　　处：《医学检验与临床》2024年第11期11-16,共6页Medical Laboratory Science and Clinics

基　　金：常州市卫健委青年人才科技项目,项目编号:QN202214。

摘　　要：目的:分析近两年我院尿培养阳性病原菌分布情况及耐药性变迁,为临床用药提供依据。方法:分别使用美国BRUKER MALDI质谱仪和Phoenix^(TM)100全自动细菌鉴定药敏仪进行细菌鉴定和抗菌药物敏感性试验,使用WHONET 5.6软件进行数据分析。结果:2021年4月-2023年4月共4163例患者尿培养阳性,其中女性多于男性,60岁以上患者占65%(2723/4163)。尿路感染检出率排名前3位的科室分别为泌尿外科、肾内科及重症医学科。共检出非重复分离细菌5283株,其中革兰阳性菌占比19.13%,革兰阴性菌占比64.38%,真菌占比15.69%。检出率排名前5位的细菌依次为大肠埃希菌(1846株,34.94%)、肺炎克雷伯菌(515株,9.75%)、白念珠菌(449株,8.50%)、粪肠球菌(394株,7.46%)和屎肠球菌(388株,7.34%)。分离细菌中大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌及铜绿假单胞菌对亚胺培南耐药率分别为0.76%、4.78%、49.06%及5.81%。结论:我院尿路感染病原菌以肠球菌、大肠埃希菌和白念珠菌为主,耐碳青霉烯类肺炎克雷伯菌和耐碳青霉烯类鲍曼不动杆菌的检出率较高,临床应高度重视。Objective:To investigate the distribution and drug resistance changes of urinary culture pathogen from April 2021 to April 2023.Methods:The US BRUKER MALDI mass spectrometer was used for bacterial identification,and the Phoenix^(TM)100 automatic bacterial identification and drug sensitivity instrument was carried out for antimicrobial susceptibility test.The data were statistically analyzed by WHONET 5.6 software.Results:From April 2021 to April 2023,4163 patients had positive urine culture,among which females were more than males,and 65%of patients over 60 years old(2723/4163).The top 3 departments with positive rate of urine culture were urology,nephrology and intensive care.A total of 5283 strains of non-repeated pathogens were detected,among which gram-positive bacteria accounted for 19.13%,gram-negative bacteria accounted for 64.38%and fungi accounted for 15.69%.The top 5 isolates were Escherichia coli(1846 strains,34.94%),Klebsiella pneumoniae(515 strains,9.75%),Candida albicans(449 strains,8.50%),Enterococcus faecalis(394 strains,7.46%)and Enterococcus faecium(388 strains,7.34%).From April 2021 to April 2023,the resistance rates of Escherichia coli to Imipenem were 0.76%.The resistance rates of Klebsiella pneumoniae to Imipenem was 4.78%.The resistance rates of Acinetobacter baumannii to Imipenem was 49.06%.The drug resistance rates of Pseudomonas aeruginosa to Imipenem was 5.81%.Conclusion:Enterococcus,Escherichia coli and Candida albicans were the main pathogens of urinary tract infection in this hospital.Carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii had high detection rates,which should be paid more attention in clinical practice.

关 键 词：尿路感染 病原菌分布 耐药 碳青霉烯酶 亚胺培南 

分 类 号：R69[医药卫生—泌尿科学]