泌尿系感染病原菌对氟喹诺酮类抗菌药物耐药性研究

STUDY ON IN VITRO ACTIVITY OF 4 FLUOROQUINOLONES AGAINST 780 STRAINS OF COMMON PATHOGENS FROM URINARY SYSTEM INFECTION

目的了解我院泌尿系感染患者病原菌分布及对4种氟喹诺酮类抗菌药物耐药情况。方法收集2003年1月—2005年10月自我院分离的780株细菌。采用纸片扩散法进行4种氟喹诺酮类抗菌药物药敏试验。结果从尿液标本分离的780株病原菌中,大肠埃希菌、肠球菌、表皮葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌分列前五位(47.2%、17.6%、9.9%、6.7%和5.4%)。大肠埃希菌产ESBLs株检出率为45.7%,肺炎克雷伯菌产ESBLs株检出率为28.6%,耐甲氧西林表皮葡萄球菌(MRSE)和高水平庆大霉素耐药肠球菌(HLGR)检出率分别为74.0%和81.0%,它们对4种氟喹诺酮类抗菌药物的耐药率高于非MRSE、非HLGR和非产ESBLs菌株,呈现多重耐药的趋势。结论大肠埃希菌仍然是泌尿系感染的主要致病菌,尿路感染应根据抗生素敏感试验选择敏感药物进行合理用药,并应检测MRSE,HL-GR和产ESBLs菌株的多重耐药情况。

Objective To investigate the distribution and drug resistance of the pathogens isolated from patients with urinary system infection in our hospital. Methods 780 isolates were collected from outpatients and inpatients of our hospital from January 2003 to October 2005. Disc agar diffusion test（K - B method） was used to study the antimicrobial resistance of 4 fluoroquinolones. Results Among these pathogens, Escherichia coli was the most common （47. 2%）, followed by Enterococcus （17. 6%） , Staphylococcus epidermidis （9. 9%） , Pseudomonas aeruginosa （6. 7%） and Klebsiella pneumoniae （5.4 % ）. The incidence of MRSE, HLGR, ESBL - producing E. coli and K. pneumoniae, were 74. 0 % ,81.0 %,45.7 % and 28.6% respectively, and their resistant rates to 4 fluoroquinolones were higher than those of their counterparts （P〈0.05）. Conclusion Escherichia coli is still the major urinary pathogens, and it is important to detect multidrug resistance of common pathogens including MRSE, HLGR, ESBL- producing E. coli and K. pneumoniae from urinary tract.