住院和门诊患者中段尿分离菌的分布及敏感性分析

Study on the distribution and drug susceptibility of pathogens in middle-segment urine sample of inpatients and outpatients

目的分析和对比住院和门诊患者中段尿分离菌的分布以及对常用抗生素的敏感性及变化趋势,为临床合理选用抗生素提供依据。方法采用ATB系统鉴定细菌,纸片扩散法做药敏试验,WHONET5.3软件分析药敏数据。结果大肠埃希菌是泌尿道感染最主要的分离菌,其次为粪肠球菌等。但2种菌所占比例明显不同。多数门诊患者中段尿分离菌的敏感性高于住院患者中段尿的分离菌,且其敏感性基本处于平稳状态,而住院患者中段尿分离菌的敏感率呈逐年下降趋势。亚胺培南治疗大肠埃希菌感染敏感性为100.0%,万古霉素对肠球菌的敏感性为100.0%。结论临床医生应关注分离菌的变迁及敏感性的情况,合理使用抗生素。

Objective To investigate the difference of distribution and antibiotic susceptibility of pathogens in middie-segment urine sample of inpatients and outpatients, for the guide of rational use of antimicrobial agents in clinic. Methods The bacteria were identified by ATB system,and K-B method was used to study the antimicrobial resistance. The data were analyzed by WHONET 5.3. Results Escherichia coli was the most common becteria in the urinary tract infections. Enterococcusfaecalis was the second. But their isolation rate was obviously different. There were higher susceptibility rate of pathogens isolated from outpatients than inpatients, and antimicrobial resistance was basically in steady status in outpatients. But the susceptibility rate of pathogens from inpatients tended to decrease year by year. Drug sensibility test in vitro of the Escherichia coli was 100.0% to imipenem,and Enterococcus faecalis was 100.0% to vancomycin. Conclusions Clinician should pay attention to the changes of pathogenic bacteria and their drug susceptibility for reasonable use of antibiotics.