近5年某医院泌尿系感染病原菌分布及耐药情况  

Distribution and Drug Resistance of Pathogens in urinary tract infection in Recent 5 Years

作　　者：王丕明[1] 卢帅 刘洁[1] 许振宗[1] WANG Pi-ming;LU Shuai;LIU Jie(Department of clinical laboratories,Shandong Provincial Corps Hospital,Chinese People's Armed Police Forces,Shandong Jinan 250014)

机构地区：[1]武警山东总队医院检验与病理科,山东济南250014

出　　处：《医学检验与临床》2025年第3期34-38,共5页Medical Laboratory Science and Clinics

摘　　要：目的:分析研究2018-2022年某医院泌尿系感染病原菌分布和耐药情况,为临床合理应用抗菌药物提供依据。方法:收集2018-2022年泌尿系感染患者尿培养标本,进行分离培养和药物敏感实验。结果:共分离出病原菌3781株,革兰阴性杆菌2260株(59.77%),革兰阳性球菌903株(23.88%),真菌600株(15.87%);前5依次为大肠埃希氏菌、肺炎克雷伯菌、屎肠球菌、白色念珠菌及光滑念珠菌。大肠埃希菌、肺炎克雷伯菌中ESBL菌株分别为44%、44.4%,大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌、铜绿假单胞菌和鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为1%、2.4%、0.78%、8.7%、70.5%和0.9%、2.4%、2.6%、7.7%、68.2%;铜绿假单胞菌对左旋氧氟沙星和哌拉西林的耐药率分别为23.9%和8.7%;鲍曼不动杆菌对左旋氧氟沙星和头孢曲松的耐药率分别为63.9%和68.2%屎肠球菌对多种抗菌药物的耐药率高于粪肠球菌,均对利奈唑胺和万古霉素有较高的敏感性。白色念珠菌对抗真菌药的耐药率均在5%以下。结论:本研究结果显示尿培养中以革兰氏阴性菌为主,主要为大肠埃希菌,临床上可将呋喃妥因和哌拉西林/他唑巴坦作为初始经验用药。Objective:To analyze the distribution and drug resistance of pathogenic bacteria generated from urine culture in a Hospital from 2018 to 2022,so as to provide basis for the correct clinical application of antimicrobial agents.Results:Totally 3781 strains of pathogenic bacteria were isolated,including 2260(59.77%)strains of gram-negative bacteria,903(23.88%)strains of grampositive bacteria and fungi 600(15.87%);The first bacteria was Escherichia coli,followed by Klebsiella pneumoniae,Enterococcus faecium,Canidia albicans,Candida glabrata.The ESBL strains in Escherichia coli and Klebsiella pneumoniae were 44%and 44.4%respectively.The drug resistance rates of Escherichia coli、Klebsiellapneumoniae,Proteussingular,Pseudomonasaeruginosaand Acinetobacter baumannito imipenem and meropenem were 1%,2.4%,0.78%,8.7%,70.5%and 0.9%,2.4%,2.6%,7.7%,68.2%respectively.The drug resistance rates of Pseudomonas aeruginosa to levofloxacin and Piperacillin were 23.9%and 8.7%respectively.The drug resistance rates of Acinetobacter baumannii to levofloxa.Methods:The pathogenic bacteria found in urine culture from 2014 to 2019 were collected and their distribution and drug sensitivity were analyzed Cin and ceftriaxone were 63.9%and 68.2%respectively.The drug resistance rate of Enterococcus faecium was higher than that of Enterococcus faecalis,and all of them were more sensitive to linezolid and vancomycin.The drug resistance rates of Canidia albicans were Less than 5%.Conclusion:The results of this study showed that gramnegative bacteria were ominant in urine culture,mainly Escherichia coli and nitrofurantoin and piperacilin/tazobactamcould be used as initial empirical drugs in clinical practice.

关 键 词：泌尿系感染 耐药 病原菌 

分 类 号：R446.5[医药卫生—诊断学]