泌尿系感染病原菌的分布及耐药性分析

Distribution of Pathogenic Bacteria in Urinary System Infection and Their Drug Resistance

目的分析泌尿系感染的菌群分布及耐药性特点,为临床选用抗菌药物提供依据。方法按照《全国临床检验操作规程》要求操作,用法国生物梅里埃公司的VITEK-60细菌鉴定仪鉴定菌种,采用K-B法做药敏试验,对临床分离的294株泌尿系感染病原菌进行鉴定及药物敏感试验。结果在分离的294株病原菌中,革兰阴性菌占75.9%、革兰阳性菌占24.1%;革兰阴性菌以大肠埃希菌为主,革兰阳性菌以肠球菌属为主;检出产超广谱β-内酰胺酶(ESBLs)菌63株,其中大肠埃希菌产ESBLs57株,占90.5%;肺炎克雷伯菌产ESBLs 6株,占9.5%;耐高单位庆大霉素肠球菌属21株,占肠球菌属43.7%。结论泌尿系感染的病原菌分布广泛,有些菌株产生多重耐药性;建议临床医生重视细菌学培养,用药敏结果指导临床合理用药,以减少ESBLs菌株的产生。

OBJECTIVE To analyze the pathogenic bacteria＇s distribution and their drug resistance in urinary system infection, and to provide the information for choosing suitable antibiotic. METHODS Totally 294 strains of pathogenic bacteria derived from the clinical urinary system infection were analyzed according to the requirements described in the National Regulations on Clinical Laboratory Operations. The bacteria were identified by the automated analyzer VITEK-60 made by Bio-Merieux Company in France and the drug resistance was analyzed with the K-B test. RESULTS In the 294 strains of bacteria, 75. 9% were Gram-negative and 24. 1% were Gram-posltive. Most of Gram-negative bacteria were Escherichia and most of Gramrpositive bacteria were Enterococcus. Sixty three strains produced extended-spectrum beta-lactamases （ESBLs）. 90. 5% （57 stains） of them were Escherichia and 9.5% percent（6 strains） were Klebsiella pneumoniae. Twenty one strains in Enterococcus resisted to high concentration gentamicin and they accounted for 43. 7% of Enterococcus. CONCLUSIONS The pathogenic bacteria in urinary system infection distribute extensively and some of them are multiple drug resistant, so we suggest that the clinicians pay more attentions to the bacteriology culture and choose the suitable antibiotic according to the results of antibiotic susceptibility tests, in order to reduce the strains producing ESBLs.