留置导尿致泌尿系感染的常见菌群及其药敏分析  

Antimicrobial susceptibility of clinical isolates from urinary tract infection patients with indwelling catheter

作　　者：韩志伟[1] 蒋维国[1] 廖常贵[1] 叶会明[1] 

机构地区：[1]四川省内江市第一人民医院检验科,641000

出　　处：《中国抗感染化疗杂志》2004年第2期93-96,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的 :了解留置导尿致泌尿系感染的常见菌群及其对抗生素的耐药性 ,以采取易行实用的预防对策 ,减少医院感染的发生率。方法 :对从 2 0 0 0年 5月— 2 0 0 3年 5月因留置导尿致泌尿系感染而分离出的 193株病原菌进行回顾性调查分析。结果 :分离出 193株病原菌中 ,革兰阴性杆菌 118株 (6 1.1% ) ,革兰阳性球菌 4 9株 (2 5 .3% ) ,真菌 2 6株 (13.5 % )。主要病原菌依次为大肠埃希菌 (35 .8% )、白念珠菌 (10 .9% )、粪肠球菌 (9.3% )、肺炎克雷伯菌 (8.3% )、铜绿假单胞菌 (5 .7% )和表皮葡萄球菌 (5 .7% )。药敏试验结果提示除真菌外的大多数病原菌出现多重耐药性。革兰阴性杆菌对亚胺培南、头孢派酮 舒巴坦、头孢西丁和阿米卡星较为敏感。革兰阳性球菌对替考拉宁和万古霉素高度敏感。 16株大肠埃希菌产超广谱 β内酰胺酶(ESBLs) ,产酶率 2 3.2 %。结论 :留置导尿致泌尿系感染的病原菌以大肠埃希菌为最常见 ,其次为白念珠菌、粪肠球菌和肺炎克雷伯菌。合理使用各种侵袭性诊疗技术及抗生素对有效控制泌尿系感染和避免耐药菌株的产生尤为重要。Objective: To investigate the common pathogens in urinary tract infection patients with indwelling catheter and their antimicrobial susceptibility. Methods:One hundred and ninety-three strains of pathogens were isolated from UTI patients with indwelling catheter from May 2000 to May 2003. Antimicrobial susceptibility test was done by Kirby-Bauer method and results interpreted according to NCCLS 1999. Results:Among 193 isolates, 118 strains (61.1%) were Gram-negative bacilli, 49 (25.3%) were Gram-positive cocci and 26(13.5%) fungi. The most common pathogens were Escherichia coli (35.8%), Candida albicans (10.9%), Enterococcus faecalis (9.3%), Klebsiella pneumoniae (8.3%), Pseudomonas aeruginosa (5.7%) and Staphylococcus epidermidis (5.7%). Most strains were multidrug resistant. Most strains of Gram-negative bacilli were highly susceptible to imipenem, cefoperazone-sulbactam, cefoxitin and amikacin, while most strains of Gram-positive cocci were highly susceptible to teicoplanin and vancomycin. 23.2%(16/69) of E.coli strains produced extended-spectrum β-lactamases. Conclusions:The most common pathogens of UTI patients with indwelling catheter are E.coli, followed by C. albicans, E. faecalis and P.aeruginosa. Prudential use of urinary catheter and rational use of antibiotics is important for the treatment of paients with UTI and reduce the development of resistant strains.

关 键 词：留置导尿 泌尿道感染 超广谱Β内酰胺酶 药敏试验 

分 类 号：R691.3[医药卫生—泌尿科学]