224例医院内尿路感染病原菌分布和耐药分析

Pathogenic bacterium distribution and antibiotics resistance analysis of nosocomial urinary tract infection

目的了解医院内尿路感染的致病因素、病原菌分布和耐药性。方法选取2004年6月至2006年6月医院内尿路感染224例进行分析。结果医院内尿路感染占医院感染18.3%。224例中,留置导尿管201例,占89.7%;发生感染时间:5d内为15.9%;14d内为91.5%;20d内为100%。培养出革兰氏阴性杆菌56.1%,真菌29.3%,革兰氏阳性球菌14.6%。其中大肠埃希菌26.8%,白假丝酵母22.0%,阴沟肠杆菌12.7%。药敏试验结果表明:对大多数革兰氏阴性杆菌有效抗菌素依次是亚胺培南、哌啦西林/舒巴坦、阿米卡星;对大多数革兰氏阳性球菌有效抗菌素依次为呋喃妥因、阿米卡星、万古霉素。结论留置导尿管时间长短是医院内尿路感染主要致病因素;病原菌以革兰氏阴性杆菌为主,而真菌感染有明显上升趋势;致病菌存在较高耐药性。

Objective To understand the disease causes of nosocomial infection, pathogenic bacterium distribution and its antibiotics resistance. Methods 224 cases of urinary tract infection patients from June 2004 to June 2006 were analyzed. Results The nosocomial urinary infection accounted for 18.3% of the hospital infection. Of 224 cases , 201 cases were caused by detaining leading urine tube, covering 89.7% . The onset time of infection were within 5 days, 15.9% ; 14 days , 91.5% ;20 days , 100%. Gram-negative becillus, fungi, gram-pnsitive bacillus, oscherichia coli, candida albicans, guam-positive coccus accounted for 56. 1% ,29.3% ,14.6% ,26.8% ,22.0% ,12.7%, respectively. Antibiotics sensitive experimental results showed ： to most gram-negative becillus, the effective antibiotics were lmipenem, Piperacillin/Sulbactam, Amikacin consecutively; to most guam-positive coccus, Furadantin, Amikacin and Vancomycin consecutively. Conclusion The prolonged time of detaining urine tube is the major risk factor of nosecomial urinary infection. The pathogenic bacterium are mainly gram-negative beeillus, with fungi a rising pathogenic bacteria. All these pathogenic bacteria show high antibiotics resistance.